Effect of Non-fluoroscopic Catheter Tracking on Radiation Exposure during Pulmonary Vein Isolation: Comparison of Four ablation systems.

Abstract

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.

• Authors: Yoshihisa Naruse, Fehmi Keçe, Marta de Riva, Masaya Watanabe, Adrianus P Wijnmaalen, Reza Alizadeh Dehnavi, Martin J Schalij, Katja Zeppenfeld, Serge A Trines
• Journal: Journal of atrial fibrillation (J Atr Fibrillation) 2018 Oct-Nov Vol. 11 Issue 3 Pg. 2068 ISSN: 1941-6911 [Print] United States
• PMID: 31139273 (Publication Type: Journal Article)