Detail publikace

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.

Originální název

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

Typ

článek v časopise ve Web of Science, Jimp

Jazyk

angličtina

Originální abstrakt

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.

Klíčová slova

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

Autoři

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

Vydáno

18. 8. 2022

Nakladatel

EP Europace

ISSN

1532-2092

Periodikum

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

Ročník

24

Číslo

10

Stát

neuvedeno

Strany od

1636

Strany do

1644

Strany počet

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"
}