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@article{2251941,
author = {Lehar, František and Szegedi, Nandor and Hejc, Jakub and Jež, Jiří and Souček, Filip and Kulík, Tomáš and Širůčková, Anna and Sallo, Zoltan and Nagy, Klaudia Vivien and Merkely, Bela and Geller, Laszlo and Stárek, Zdeněk},
article_location = {Oxford},
article_number = {10},
doi = {http://dx.doi.org/10.1093/europace/euac049},
keywords = {Catheter ablation of arrhythmias; Supraventricular tachycardias; Fluoroscopic guidance; Zero fluoro procedures; Radiation exposure; Effective dose; Three-dimensional electroanatomical mapping system},
language = {eng},
issn = {1099-5129},
journal = {EP Europace},
title = {Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study},
url = {https://academic.oup.com/europace/article/24/10/1636/6670970?login=true},
volume = {24},
year = {2022}
}
TY - JOUR
ID - 2251941
AU - Lehar, František - Szegedi, Nandor - Hejc, Jakub - Jež, Jiří - Souček, Filip - Kulík, Tomáš - Širůčková, Anna - Sallo, Zoltan - Nagy, Klaudia Vivien - Merkely, Bela - Geller, Laszlo - Stárek, Zdeněk
PY - 2022
TI - Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study
JF - EP Europace
VL - 24
IS - 10
SP - 1636-1644
EP - 1636-1644
PB - Oxford University Press
SN - 10995129
KW - Catheter ablation of arrhythmias
KW - Supraventricular tachycardias
KW - Fluoroscopic guidance
KW - Zero fluoro procedures
KW - Radiation exposure
KW - Effective dose
KW - Three-dimensional electroanatomical mapping system
UR - https://academic.oup.com/europace/article/24/10/1636/6670970?login=true
N2 - Background Interventional cardiology procedures may expose patients and staff to considerable radiation doses. We aimed to assess whether exposure to ionizing radiation during catheter ablation of supraventricular tachycardia (SVT) can be completely avoided. Methods In this prospective randomized study, patients with SVT (atrioventricular re-entrant tachycardia n = 94, typical atrial flutter n = 29) were randomly assigned in a 1:1 ratio to catheter ablation with conventional fluoroscopic guidance (CF group) or with the EnSite Precision mapping system [zerofluoro (ZF) group]. Acute procedural parameters, increased stochastic risk of cancer incidence and 6-month follow-up data were assessed. Results Between May 2019 and August 2020, 123 patients were enrolled. Clinical parameters were comparable. Median procedural time was 60.0 and 58.0 min, median fluoroscopy time and estimated median effective dose were 240 s vs. 0 and 0.38 mSv vs. 0 and arrhythmia recurrence was 5% and 7.9% in the CF and ZF groups, respectively. The acute success rate was 98.4% in both groups. No procedure-related complications were reported. At an average age of 55.5 years and median radiation exposure of 0.38 mSv, the estimate of increased incidence was approximately 1 in 14 084. The estimated mortality rate was 1 per 17 857 exposed persons. Conclusions The procedural safety and efficacy of the zero-fluoroscopic approach are similar to those of conventional fluoroscopy-based ablation for atrioventricular nodal re-entrant tachycardia and atrial flutter. Under the assumption of low radiation dose, the excessive lifetime risk of malignancy in the CF group due to electrophysiology procedure is reasonably small, whilst totally reduced in zero fluoroscopy procedures.
ER -
LEHAR, František, Nandor SZEGEDI, Jakub HEJC, Jiří JEŽ, Filip SOUČEK, Tomáš KULÍK, Anna ŠIRŮČKOVÁ, Zoltan SALLO, Klaudia Vivien NAGY, Bela MERKELY, Laszlo GELLER and Zdeněk STÁREK. Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study. \textit{EP Europace}. Oxford: Oxford University Press, 2022, vol.~24, No~10, p.~1636-1644. ISSN~1099-5129. Available from: https://dx.doi.org/10.1093/europace/euac049.
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