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Huo Y, Christoph M, Forkmann M, Pohl M, Mayer J, Salmas J, Sitzy J, Wunderlich C, Piorkowski C, Gaspar T. Reduction of radiation exposure during atrial fibrillation ablation using a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping system: A prospective, randomized, single-blind, and controlled study. Heart Rhythm 2015; 12:1945-55. [PMID: 26001508 DOI: 10.1016/j.hrthm.2015.05.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We explored whether the use of a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping (F-EAM) system could result in a reduction of overall fluoroscopy time and radiation doses during the whole procedure of atrial fibrillation (AF) ablation. METHODS Eighty patients (44 men (55%); mean age 63 ± 10 years) who underwent catheter ablation due to paroxysmal AF were recruited consecutively in the present study. Patients were randomized (1:1) into 2 arms for AF ablation: one using a conventional 3-dimensional electroanatomical mapping (EAM) system and the other using the F-EAM system. RESULTS Fluoroscopy time (10:42 [interquartile range {IQR} 8:45-12:46] minutes:seconds vs 1:45 [IQR 1:05-2:22] minutes:seconds; P < .001) and radiation doses (2440 [IQR 1593-3091] cGy·cm(2) vs 652 [IQR 326-1489] cGy·cm(2); P < .001) in the EAM group were significantly greater than those in the F-EAM group. The majority of reduction of radiation exposure was achieved after transseptal puncture, which was near-zero fluoroscopic exposure. In total, approximately 84% of fluoroscopy time and 73% of radiation doses have been reduced during the AF ablation procedure using the F-EAM system compared to using the conventional EAM system. However, procedure time did not differ significantly (1:39 [IQR 1:18-2:10] hours:minutes vs 1:37 [IQR 1:17-1:50] hours:minutes; P = .362). During follow-up (5.9 ± 1.3 months), 61 patients (76.3%) had no recurrence of atrial arrhythmias. The recurrence rate between the 2 groups did not differ. CONCLUSION AF catheter ablation using the F-EAM system was safe and resulted in a significant reduction of radiation exposure to patients and staff without complicating the workflow of the procedure. A near-zero fluoroscopic catheter ablation procedure could be performed without compromising acute/mid-term efficacy and safety.
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Affiliation(s)
- Yan Huo
- Steinbeis Research Institute 'Electrophysiology and Cardiac Devices', Dresden, Germany; Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany.
| | - Marian Christoph
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Mathias Forkmann
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Matthias Pohl
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Julia Mayer
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Jozef Salmas
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Judith Sitzy
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Carsten Wunderlich
- Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Christopher Piorkowski
- Steinbeis Research Institute 'Electrophysiology and Cardiac Devices', Dresden, Germany; Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
| | - Thomas Gaspar
- Steinbeis Research Institute 'Electrophysiology and Cardiac Devices', Dresden, Germany; Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany
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