Yan Huo1, Marian Christoph2, Mathias Forkmann2, Matthias Pohl2, Julia Mayer2, Jozef Salmas2, Judith Sitzy2, Carsten Wunderlich2, Christopher Piorkowski3, Thomas Gaspar3. 1. Steinbeis Research Institute 'Electrophysiology and Cardiac Devices', Dresden, Germany; Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany. Electronic address: dr.huoyan@googlemail.com. 2. Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany. 3. Steinbeis Research Institute 'Electrophysiology and Cardiac Devices', Dresden, Germany; Department of Electrophysiology, Heart Center Dresden, Dresden University of Technology, Dresden, Germany.
Abstract
OBJECTIVE: We explored whether the use of a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping (F-EAM) system could result in a reduction of overall fluoroscopy time and radiation doses during the whole procedure of atrial fibrillation (AF) ablation. METHODS:Eighty patients (44 men (55%); mean age 63 ± 10 years) who underwent catheter ablation due to paroxysmal AF were recruited consecutively in the present study. Patients were randomized (1:1) into 2 arms for AF ablation: one using a conventional 3-dimensional electroanatomical mapping (EAM) system and the other using the F-EAM system. RESULTS:Fluoroscopy time (10:42 [interquartile range {IQR} 8:45-12:46] minutes:seconds vs 1:45 [IQR 1:05-2:22] minutes:seconds; P < .001) and radiation doses (2440 [IQR 1593-3091] cGy·cm(2) vs 652 [IQR 326-1489] cGy·cm(2); P < .001) in the EAM group were significantly greater than those in the F-EAM group. The majority of reduction of radiation exposure was achieved after transseptal puncture, which was near-zero fluoroscopic exposure. In total, approximately 84% of fluoroscopy time and 73% of radiation doses have been reduced during the AF ablation procedure using the F-EAM system compared to using the conventional EAM system. However, procedure time did not differ significantly (1:39 [IQR 1:18-2:10] hours:minutes vs 1:37 [IQR 1:17-1:50] hours:minutes; P = .362). During follow-up (5.9 ± 1.3 months), 61 patients (76.3%) had no recurrence of atrial arrhythmias. The recurrence rate between the 2 groups did not differ. CONCLUSION:AF catheter ablation using the F-EAM system was safe and resulted in a significant reduction of radiation exposure to patients and staff without complicating the workflow of the procedure. A near-zero fluoroscopic catheter ablation procedure could be performed without compromising acute/mid-term efficacy and safety.
RCT Entities:
OBJECTIVE: We explored whether the use of a novel fluoroscopy image integrated 3-dimensional electroanatomic mapping (F-EAM) system could result in a reduction of overall fluoroscopy time and radiation doses during the whole procedure of atrial fibrillation (AF) ablation. METHODS: Eighty patients (44 men (55%); mean age 63 ± 10 years) who underwent catheter ablation due to paroxysmal AF were recruited consecutively in the present study. Patients were randomized (1:1) into 2 arms for AF ablation: one using a conventional 3-dimensional electroanatomical mapping (EAM) system and the other using the F-EAM system. RESULTS: Fluoroscopy time (10:42 [interquartile range {IQR} 8:45-12:46] minutes:seconds vs 1:45 [IQR 1:05-2:22] minutes:seconds; P < .001) and radiation doses (2440 [IQR 1593-3091] cGy·cm(2) vs 652 [IQR 326-1489] cGy·cm(2); P < .001) in the EAM group were significantly greater than those in the F-EAM group. The majority of reduction of radiation exposure was achieved after transseptal puncture, which was near-zero fluoroscopic exposure. In total, approximately 84% of fluoroscopy time and 73% of radiation doses have been reduced during the AF ablation procedure using the F-EAM system compared to using the conventional EAM system. However, procedure time did not differ significantly (1:39 [IQR 1:18-2:10] hours:minutes vs 1:37 [IQR 1:17-1:50] hours:minutes; P = .362). During follow-up (5.9 ± 1.3 months), 61 patients (76.3%) had no recurrence of atrial arrhythmias. The recurrence rate between the 2 groups did not differ. CONCLUSION:AF catheter ablation using the F-EAM system was safe and resulted in a significant reduction of radiation exposure to patients and staff without complicating the workflow of the procedure. A near-zero fluoroscopic catheter ablation procedure could be performed without compromising acute/mid-term efficacy and safety.
Authors: Silvia Guarguagli; Ilaria Cazzoli; Aleksander Kempny; Michael A Gatzoulis; Sabine Ernst Journal: Cardiol Res Pract Date: 2020-06-20 Impact factor: 1.866
Authors: Thomas Kleemann; Johannes Brachmann; Thorsten Lewalter; Dietrich Andresen; Stephan Willems; Stefan G Spitzer; Ellen Hoffmann; Lars Eckardt; Matthias Hochadel; Jochen Senges; Karl-Heinz Kuck; Karlheinz Seidl; Ralf Zahn Journal: Clin Res Cardiol Date: 2016-05-03 Impact factor: 5.460
Authors: Simon Wechselberger; Mads Kronborg; Yan Huo; Judith Piorkowski; Sebastian Neudeck; Ellen Päßler; Ali El-Armouche; Utz Richter; Julia Mayer; Stefan Ulbrich; Liying Pu; Bettina Kirstein; Thomas Gaspar; Christopher Piorkowski Journal: Europace Date: 2018-11-01 Impact factor: 5.214