Details

Autor(en) / Beteiligte

• Cano, Óscar
• Saurí, Assumpció
• Plaza, Diego
• Osca, Joaquín
• Sancho-Tello, María-José
• Rueda, Joaquín
• Osa, Ana
• Martínez-Dolz, Luis

Titel

Evaluation of a near-zero fluoroscopic approach for catheter ablation in patients with congenital heart disease

Ist Teil von

• Journal of interventional cardiac electrophysiology, 2019-12, Vol.56 (3), p.259-269

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2019

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Purpose Radiation exposure (RE) is a matter of concern for patients with congenital heart disease (CHD) who not infrequently need multiple interventional procedures under fluoroscopy guidance. We sought to evaluate the safety and feasibility of a minimally fluoroscopic approach in patients with CHD undergoing catheter ablation using a new image integration module (IIM). Methods Consecutive patients with CHD undergoing catheter ablation using the Carto Univu™ IIM were included. A near-zero fluoroscopy procedure was defined by an effective dose (ED) ≤ 1 mSv. RE parameters (total fluoroscopy time [TFT], total dose area product [tDAP], and ED), ablation outcomes, and complications were evaluated. Results Fifty-five patients with CHD underwent 63 ablation procedures (supraventricular tachycardia, n  = 53; ventricular tachycardia, n  = 10). The CHD was simple in 25%, moderate in 42%, and complex in 33%. The use of the IIM resulted in very low levels of RE (median TFT 0.13 min [IQR 0–1.04], median tDAP 54.5 cGy cm 2 [IQR 9.5–176.4], median ED 0.136 mSv [IQR 0.02–0.49]). Patients with complex CHD had significantly higher RE when compared with patients with simple and moderate defects. A total of 56/63 ablation procedures (89%) were performed with an ED ≤ 1 mSv. One patient developed sinus node dysfunction requiring pacemaker implantation. Conclusions The use of a minimally fluoroscopic approach was safe and feasible resulting in very low RE during catheter ablation of patients with CHD. A near-zero fluoroscopy ablation was possible in up to 89% of the procedures.