Sebastian Stec1,2,3, Janusz Śledź2,4,5, Mariusz Mazij6, Małgorzata Raś6, Bartosz Ludwik6, Michał Chrabąszcz2,7, Arkadiusz Śledź2, Małgorzata Banasik2, Magdalena Bzymek2, Krzysztof Młynarczyk8, Karol Deutsch1, Michał Labus6, Jerzy Śpikowski6, Lesław Szydłowski9. 1. Department of Cardiology, Medical Center for Postgraduate Education, Grochowski Hospital, Warsaw. 2. ELMedica EP-Network, Kielce. 3. Podkarpackie Center for Cardiovascular Interventions, Sanok. 4. Carint Medica, Kraków. 5. Division of Interventional Cardiology, Center of Invasive Cardiology, Angiology and Electrotherapy in Ostrowiec, Poland. 6. Department of Cardiology and Pediatric Cardiology, Research and Development Center, Wrovasc, Voivodship's Specialist Hospital, Wroclaw. 7. Institute of Physics, Department of Atomic Physics, Jan Kochanowski University, Kielce. 8. Department of Cardiology, Specialist Hospital, Tarnow. 9. Department of Pediatric Cardiology, Silesian Medical University, Katowice, Poland.
Abstract
INTRODUCTION: Although the "near-zero-X-Ray" or "No-X-Ray" catheter ablation (CA) approach has been reported for treatment of various arrhythmias, few prospective studies have strictly used "No-X-Ray," simplified 2-catheter approaches for CA in patients with supraventricular tachycardia (SVT). We assessed the feasibility of a minimally invasive, nonfluoroscopic (MINI) CA approach in such patients. METHODS: Data were obtained from a prospective multicenter CA registry of patients with regular SVTs. After femoral access, 2 catheters were used to create simple, 3D electroanatomic maps and to perform electrophysiologic studies. Medical staff did not use lead aprons after the first 10 MINI CA cases. RESULTS: A total of 188 patients (age, 45 ± 21 years; 17% <19 years; 55% women) referred for the No-X-Ray approach were included. They were compared to 714 consecutive patients referred for a simplified approach using X-rays (age, 52 ± 18 years; 7% <19 years; 55% women). There were 9 protocol exceptions that necessitated the use of X-rays. Ultimately, 179/188 patients underwent the procedure without fluoroscopy, with an acute success rate of 98%. The procedure times (63 ± 26 vs. 63 ± 29 minutes, P > 0.05), major complications (0% vs. 0%, P > 0.05) and acute (98% vs. 98%, P > 0.05) and long-term (93% vs. 94%, P > 0.05) success rates were similar in the "No-X-Ray" and control groups. CONCLUSIONS: Implementation of a strict "No-X-Ray, simplified 2-catheter" CA approach is safe and effective in majority of the patients with SVT. This modified approach for SVTs should be prospectively validated in a multicenter study.
INTRODUCTION: Although the "near-zero-X-Ray" or "No-X-Ray" catheter ablation (CA) approach has been reported for treatment of various arrhythmias, few prospective studies have strictly used "No-X-Ray," simplified 2-catheter approaches for CA in patients with supraventricular tachycardia (SVT). We assessed the feasibility of a minimally invasive, nonfluoroscopic (MINI) CA approach in such patients. METHODS: Data were obtained from a prospective multicenter CA registry of patients with regular SVTs. After femoral access, 2 catheters were used to create simple, 3D electroanatomic maps and to perform electrophysiologic studies. Medical staff did not use lead aprons after the first 10 MINI CA cases. RESULTS: A total of 188 patients (age, 45 ± 21 years; 17% <19 years; 55% women) referred for the No-X-Ray approach were included. They were compared to 714 consecutive patients referred for a simplified approach using X-rays (age, 52 ± 18 years; 7% <19 years; 55% women). There were 9 protocol exceptions that necessitated the use of X-rays. Ultimately, 179/188 patients underwent the procedure without fluoroscopy, with an acute success rate of 98%. The procedure times (63 ± 26 vs. 63 ± 29 minutes, P > 0.05), major complications (0% vs. 0%, P > 0.05) and acute (98% vs. 98%, P > 0.05) and long-term (93% vs. 94%, P > 0.05) success rates were similar in the "No-X-Ray" and control groups. CONCLUSIONS: Implementation of a strict "No-X-Ray, simplified 2-catheter" CA approach is safe and effective in majority of the patients with SVT. This modified approach for SVTs should be prospectively validated in a multicenter study.
Authors: Matevž Jan; David Žižek; Dimitrij Kuhelj; Nikola Lakič; Tine Prolič Kalinšek; Jernej Štublar; Luka Klemen; Andrej Pernat; Bor Antolič Journal: Int J Cardiovasc Imaging Date: 2019-11-11 Impact factor: 2.357
Authors: Karol Deutsch; Janusz Śledź; Mariusz Mazij; Bartosz Ludwik; Michał Labus; Dariusz Karbarz; Bernadetta Pasicka; Michał Chrabąszcz; Arkadiusz Śledź; Monika Klank-Szafran; Laura Vitali-Sendoz; Tomasz Kameczura; Jerzy Śpikowski; Piotr Stec; Marek Ujda; Sebastian Stec Journal: Medicine (Baltimore) Date: 2017-06 Impact factor: 1.889
Authors: Edward Koźluk; Agnieszka Piątkowska; Dariusz Rodkiewicz; Michał Peller; Janusz Kochanowski; Grzegorz Opolski Journal: Arch Med Sci Date: 2017-05-30 Impact factor: 3.318
Authors: Aleksandra Morka; Janusz Śledź; Karol Deutsch; Bartosz Ludwik; Magdalena Zagrodzka; Lesław Szydłowski; Sebastian Stec Journal: Medicine (Baltimore) Date: 2019-10 Impact factor: 1.817
Authors: Katarzyna Styczkiewicz; Bartosz Ludwik; Marek Styczkiewicz; Janusz Śledź; Małgorzata Gorski; Sebastian Stec Journal: Int J Cardiovasc Imaging Date: 2021-10-28 Impact factor: 2.357
Authors: Dariusz Rodkiewicz; Edward Koźluk; Agnieszka Piątkowska; Aleksandra Gąsecka; Krzysztof Krzemiński; Grzegorz Opolski Journal: J Clin Med Date: 2022-03-25 Impact factor: 4.241
Authors: Karol Deutsch; Sebastian Stec; Piotr Kukla; Aleksandra Morka; Marek Jastrzebski; Artur Baszko; Maciej Pitak; Janusz Sledz; Kamil Fijorek; Mariusz Mazij; Bartosz Ludwik; Marcin Gubaro; Leslaw Szydlowski Journal: Medicine (Baltimore) Date: 2015-12 Impact factor: 1.817