J 2022

Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study

LEHAR, František, Nandor SZEGEDI, Jakub HEJC, Jiří JEŽ, Filip SOUČEK et. al.

Basic information

Original name

Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study

Authors

LEHAR, František (203 Czech Republic, belonging to the institution), Nandor SZEGEDI, Jakub HEJC, Jiří JEŽ (203 Czech Republic, belonging to the institution), Filip SOUČEK (203 Czech Republic, belonging to the institution), Tomáš KULÍK (203 Czech Republic, belonging to the institution), Anna ŠIRŮČKOVÁ (203 Czech Republic, belonging to the institution), Zoltan SALLO, Klaudia Vivien NAGY, Bela MERKELY, Laszlo GELLER and Zdeněk STÁREK (203 Czech Republic, guarantor, belonging to the institution)

Edition

EP Europace, Oxford, Oxford University Press, 2022, 1099-5129

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 6.100

RIV identification code

RIV/00216224:14110/22:00128480

Organization unit

Faculty of Medicine

DOI

UT WoS

000841952900001

Keywords in English

Catheter ablation of arrhythmias; Supraventricular tachycardias; Fluoroscopic guidance; Zero fluoro procedures; Radiation exposure; Effective dose; Three-dimensional electroanatomical mapping system

Tags

Tags

International impact, Reviewed
Změněno: 1/2/2023 13:10, Mgr. Tereza Miškechová

Abstract

V originále

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.