Publication detail

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

LEHAR, F. SZEGEDI, N. HEJČ, J. JEZ, J. SOUCEK, F. KULÍK, T. ŠIRŮČKOVÁ, A. SALO, Z. NAGY, K. MERKELY, B. GELLER, L. STÁREK, Z.

Original Title

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

Type

journal article in Web of Science

Language

English

Original Abstract

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. 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. 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. 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.

Keywords

catheter ablation, supraventricular tachycardia, zero fluoroscopy, electroanatomical mapping, radiation dose, excessive lifetime risk

Authors

LEHAR, F.; SZEGEDI, N.; HEJČ, J.; JEZ, J.; SOUCEK, F.; KULÍK, T.; ŠIRŮČKOVÁ, A.; SALO, Z.; NAGY, K.; MERKELY, B.; GELLER, L.; STÁREK, Z.

Released

18. 8. 2022

Publisher

EP Europace

ISBN

1532-2092

Periodical

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

Year of study

24

Number

10

State

unknown

Pages from

1636

Pages to

1644

Pages count

9

URL

https://academic.oup.com/europace/article-abstract/24/10/1636/6670970

BibTex

@article{BUT179935,
  author="Frantisek {Lehar} and Nandor {Szegedi} and Jakub {Hejč} and Jiri {Jez} and Filip {Soucek} and Tomáš {Kulík} and Anna {Širůčková} and Zoltan {Salo} and Klaudia Vivien {Nagy} and Bela {Merkely} and László {Geller} and Zdeněk {Stárek}",
  title="Randomized comparison of atrioventricular node re-entry tachycardia and atrial flutter catheter ablation with and without fluoroscopic guidance: ZeroFluoro study",
  journal="Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology",
  year="2022",
  volume="24",
  number="10",
  pages="1636--1644",
  doi="10.1093/europace/euac049",
  issn="1532-2092",
  url="https://academic.oup.com/europace/article-abstract/24/10/1636/6670970"
}