Cited 1 times since 2018 (0.2 per year) source: EuropePMC Journal of atrial fibrillation, Volume 11, Issue 3, 31 5 2018, Pages 2068 Effect of Non-fluoroscopic Catheter Tracking on Radiation Exposure during Pulmonary Vein Isolation: Comparison of Four ablation systems. Naruse Y, Keçe F, de Riva M, Watanabe M, Wijnmaalen AP, Dehnavi RA, Schalij MJ, Zeppenfeld K, Trines SA

Background

A novel non-fluoroscopic catheter tracking system (Mediguide) can be used in combination with a 3D mapping system for atrial fibrillation (AF) ablation. However, the benefit on radiation exposure of the Mediguide system compared to other ablation systems is unknown.

Methods

We retrospectively enrolled consecutive 73 patients (51 men; 59±11 years; 60 paroxysmal AF) undergoing pulmonary vein isolation by the same operator. Radiation time, radiation effective dose, procedure time, AF recurrence after ablation, and procedure-related complications were compared among 4 different ablation systems.

Results

Mediguide was used in 16 patients (group A), CARTO™ in 17 (group B), Cryoballoon in 30 (group C), and Multi-electrode Pulmonary Vein Ablation Catheter (PVAC) in 10 (group D). Although procedure time was shorter in patients with Cryoballoon (median 110 [interquartile range 99-120] min) and PVAC (123 [112-146] min) compared to those with Mediguide (181 [168-214] min) and CARTO (179 [160-195] min) (P<0.001), radiation exposure time and effective dose were decreased in patients with Mediguide compared to the other ablation systems (A: 5 [3-6] min; B: 14 [11-16] min; C: 14 [11-18] min; D: 20 [16-24] min, P<0.001 and A: 1.1 [0.8-2.0] mSv; B: 2.5 [1.3-3.8] mSv; C: 2.0 [1.4-2.5] mSv; D: 1.7 [1.4-3.6] mSv, P=0.015, respectively). AF recurrence rates and procedure-related complications were comparable among the 4 groups.

Conclusion

The Mediguide system reduces radiation exposure compared to other ablation systems without increasing AF recurrence or procedure-related complications.

J Atr Fibrillation. 2018 10;11(3):2068