Zero-fluoroscopy approach for ablation of supraventricular tachycardia using the Ensite NavX system: a multicenter experience
Guangzhi Chen, Yan Wang, Riccardo Proietti, Xunzhang Wang, Feifan Ouyang, Chang Sheng Ma, Rong Hui Yu, Chunxia Zhao, Kezhong Ma, Jie Qiu, Qigong Liu, Dao Wen Wang, Guangzhi Chen, Yan Wang, Riccardo Proietti, Xunzhang Wang, Feifan Ouyang, Chang Sheng Ma, Rong Hui Yu, Chunxia Zhao, Kezhong Ma, Jie Qiu, Qigong Liu, Dao Wen Wang
Abstract
Background: Three-dimensional electroanatomic mapping systems have demonstrated a significant reduction in radiation exposure during radiofrequency catheter ablation procedures. We aimed to investigate the safety, feasibility and efficacy of a completely zero-fluoroscopy approach for catheter ablation of supraventricular tachycardia using the Ensite NavX navigation system compared with a conventional fluoroscopy approach.
Methods: A multicenter prospective non-randomized registry study was performed in seven centers from January 2013 to February 2018. Consecutive patients referred for catheter ablation of supraventricular tachycardia were assigned either to a completely zero-fluoroscopic approach (ZF) or conventional fluoroscopy approach (CF) according to the operator's preference. Patients with atrial tachycardia were excluded.
Results: Totally, 1020 patients were enrolled in ZF group; 2040 patients ablated by CF approach were selected for controls. There was no significant difference between the zero-fluoroscopy group and conventional fluoroscopy group as to procedure time (60.3 ± 20.3 vs. 59.7 ± 22.6 min, P = 0.90), immediate success rate of procedure (98.8% vs. 99.2%, P = 0.22), arrhythmia recurrence (0.4% vs. 0.5%, P = 0.85), total success rate of procedure (98.4% vs. 98.8%, P = 0.39) or complications (1.1% vs. 1.5%, P = 0.41). Compared with the conventional fluoroscopy approach, the zero-fluoroscopy approach provided similar outcomes without compromising the safety or efficacy of the procedure.
Conclusion: The completely zero-fluoroscopy approach demonstrated safety and efficacy comparable to a conventional fluoroscopy approach for catheter ablation of supraventricular tachycardia, and mitigated radiation exposure to both patients and operators.
Trial registration: clinicaltrials.gov Identifier: NCT03042078; first registered February 3, 2017; retrospectively registered.
Keywords: Radiation exposure; Radiofrequency ablation; Supraventricular tachycardia; Zero-fluoroscopy.
Conflict of interest statement
The authors declare that they have no competing interests.
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Source: PubMed