Marco Bergonti1, Antonio Dello Russo2, Rita Sicuso3, Valentina Ribatti3, Paolo Compagnucci2, Valentina Catto3, Alessio Gasperetti4, Martina Zucchetti3, Selene Cellucci3, Giulia Vettor3, Maria Antonietta Dessanai3, Benedetta Majocchi3, Massimo Moltrasio3, Eleonora Russo5, Giulia Stronati2, Federico Guerra2, Luigi Di Biase6, Andrea Natale7, Claudio Tondo8, Michela Casella9. 1. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy. Electronic address: bergmar21@gmail.com. 2. Cardiology and Arrhythmology Clinic, University Hospital "Umberto I-Lancisi-Salesi," Marche Polytechnic University, Ancona, Italy; Department of Biomedical Sciences and Public Health, University Hospital "Umberto I-Lancisi-Salesi," Marche Polytechnic University, Ancona, Italy. 3. Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy. 4. Department of Biomedical Sciences and Public Health, University Hospital "Umberto I-Lancisi-Salesi," Marche Polytechnic University, Ancona, Italy. 5. Department of Cardiovascular Disease, Division of Cardiac Surgery, Casa Sollievo della Sofferenza IRCCS, San Giovanni Rotondo, Italy. 6. Montefiore Medical Center, Albert-Einstein College of Medicine, Bronx, New York, USA. 7. Texas Cardiac Arrhythmia Institute (TCAI), St. David's Hospital, Austin, Texas, USA. 8. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino IRCCS, Milan, Italy. 9. Cardiology and Arrhythmology Clinic, University Hospital "Umberto I-Lancisi-Salesi," Marche Polytechnic University, Ancona, Italy; Department of Clinical, Special and Dental Sciences, University Hospital "Umberto I-Lancisi-Salesi," Marche Polytechnic University, Ancona, Italy.
Abstract
OBJECTIVES: This study aimed to assess the long-term outcomes of minimally fluoroscopic approach (MFA) compared with conventional fluoroscopic ablation (ConvA) in terms of recurrences of arrhythmia and long-term complications. BACKGROUND: Catheter ablation (CA) of supraventricular tachycardia (SVT) with an MFA, under the guidance of electroanatomic mapping (EAM) systems, results in a significant reduction in exposure to ionizing radiations without impairing acute procedural success and complication rate. However, data regarding long-term outcomes of MFA compared with ConvA are lacking. METHODS: This is a retrospective observational study. All patients undergoing MFA CA of SVT (atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia) between 2010 and 2015 were enrolled and were compared with matched subjects (1 MFA: 2 ConvA) undergoing ConvA during the same period. The 2 co-primary outcomes were recurrence of arrhythmias and long-term complications. RESULTS: Six-hundred eighteen patients (mean age 38 ± 15 years, 60% female) were enrolled. MFA included 206 patients, whereas 412 were treated with ConvA. Acute success (99% vs. 97%; p = 0.10) and acute complications (2.4% vs. 5.3%; p = 0.14) were similar in the 2 groups. During a median follow-up of 4.4 years, 5.9% of patients experienced recurrence of arrhythmias. At multivariate analysis, ConvA (hazard ratio [HR]: 3.03) and procedural success (HR: 0.10) were independently associated with recurrence of arrhythmias. Late complications (i.e., advance atrioventricular block and need for pacemaker implantation) occurred more frequently in ConvA (3.4% vs. 0.5%; p = 0.03) compared with MFA. CONCLUSIONS: CA guided by EAM systems with MFA provided better long-term results and reduced risk of complications compared with ConvA.
OBJECTIVES: This study aimed to assess the long-term outcomes of minimally fluoroscopic approach (MFA) compared with conventional fluoroscopic ablation (ConvA) in terms of recurrences of arrhythmia and long-term complications. BACKGROUND: Catheter ablation (CA) of supraventricular tachycardia (SVT) with an MFA, under the guidance of electroanatomic mapping (EAM) systems, results in a significant reduction in exposure to ionizing radiations without impairing acute procedural success and complication rate. However, data regarding long-term outcomes of MFA compared with ConvA are lacking. METHODS: This is a retrospective observational study. All patients undergoing MFA CA of SVT (atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia) between 2010 and 2015 were enrolled and were compared with matched subjects (1 MFA: 2 ConvA) undergoing ConvA during the same period. The 2 co-primary outcomes were recurrence of arrhythmias and long-term complications. RESULTS: Six-hundred eighteen patients (mean age 38 ± 15 years, 60% female) were enrolled. MFA included 206 patients, whereas 412 were treated with ConvA. Acute success (99% vs. 97%; p = 0.10) and acute complications (2.4% vs. 5.3%; p = 0.14) were similar in the 2 groups. During a median follow-up of 4.4 years, 5.9% of patients experienced recurrence of arrhythmias. At multivariate analysis, ConvA (hazard ratio [HR]: 3.03) and procedural success (HR: 0.10) were independently associated with recurrence of arrhythmias. Late complications (i.e., advance atrioventricular block and need for pacemaker implantation) occurred more frequently in ConvA (3.4% vs. 0.5%; p = 0.03) compared with MFA. CONCLUSIONS: CA guided by EAM systems with MFA provided better long-term results and reduced risk of complications compared with ConvA.
Authors: Federica Troisi; Pietro Guida; Federico Quadrini; Antonio Di Monaco; Nicola Vitulano; Rosa Caruso; Rocco Orfino; Giacomo Cecere; Matteo Anselmino; Massimo Grimaldi Journal: Front Cardiovasc Med Date: 2022-04-28
Authors: Paolo Compagnucci; Antonio Dello Russo; Marco Bergonti; Matteo Anselmino; Giulio Zucchelli; Alessio Gasperetti; Laura Cipolletta; Giovanni Volpato; Ciro Ascione; Federico Ferraris; Yari Valeri; Maria Grazia Bongiorni; Andrea Natale; Claudio Tondo; Gaetano Maria De Ferrari; Michela Casella Journal: J Clin Med Date: 2022-03-24 Impact factor: 4.241