Long-term outcomes after “Zero X-ray” arrhythmia ablation

• DOI: 10.1007/s10840-018-0390-7
• Publication Date: 2018-06-12T12:13:15Z
• Authors: Marzia Giaccardi; Giuseppe Mascia; Alessandro Paolet...; Andrea Giomi; Stella Cartei; Massimo Milli
• Keywords: Male; Time Factors; Body Surface Potential Mapping; Operative Time; Middle Aged; Radiation Exposure; Risk Assessment; Severity of Illness Index; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Italy; Recurrence; Fluoroscopy; Catheter Ablation; Tachycardia, Supraventricular; Humans; Female; Patient Safety; Aged; Follow-Up Studies; Retrospective Studies

Radiation exposure related to conventional tachyarrhythmia radiofrequency catheter ablation (RFCA) carries small but definite risk for both patients and operators. Today, non-fluoroscopic mapping systems enable to perform catheter ablation with minimal or zero fluoroscopy. The purpose of this study was to evaluate the long-term outcome of patients who had undergone "Zero X-ray" ablation, since no information is available on the very long-term benefits.A total of 272 arrhythmias in 266 patients have been treated with catheter ablation by means of a zero-ray approach guided only by a nonconventional mapping system (EnSite NavX™, Ensite™ Velocity™ mapping system; subsequently Ensite™ Precision™ Abbott, St. Paul, MN). Fluoroscopy was never used.Over a period of 6 years, patients were followed up for an average of 2.9 ± 1.6 years. A 100% rate of acute success was observed in the study population, with a complication rate of 0.8%. Chronic success was achieved in 90.8% of the total number of procedures (272). Patients in whom the same arrhythmia recurred during follow-up underwent to a redo catheter ablation procedure in 60.0% of cases, while the remaining 40.0% underwent pharmacological treatment. A new post-ablation arrhythmia occurred in 7.7% of the sample.The non-fluoroscopic approach is a feasible and safe alternative to fluoroscopy for arrhythmias ablation. This method ensures low complications rates, high acute procedural success rates, and comparable long-term outcomes with clinical benefits for both patients and physicians. The complete elimination of fluoroscopy during catheter ablation is advantageous and does not reduce patient safety.