Transseptal puncture during catheter ablation associated with higher radiation exposure.

Autor:	Rahman M; The Heart Center, Akron Children's Hospital, Akron, OH, USA., Smith G; The Heart Center, Akron Children's Hospital, Akron, OH, USA., Johnsrude C; Division of Pediatric Cardiology, Department of Pediatrics, Norton Children's Heart Institute, Louisville, KY, USA., LaPage M; Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA., Moore J; Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, CA, USA., Shannon K; Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, CA, USA., Anderson C; Center for Congenital Heart Disease, Providence Sacred Heart Children's Hospital, Spokane, WA, USA., Papagiannis J; Division of Cardiology, Children's Mercy Hospital, Kansas City, MO, USA., Lau K; Division of Pediatric Cardiology, Department of Pediatrics, Norton Children's Heart Institute, Louisville, KY, USA., Sanatani S; Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, BC, Canada., Razminia M; Clinical Cardiac Electrophysiology, Amita Health Saint Joseph Hospital, Elgin, IL, USA., Tuzcu V; Department of Pediatric Cardiology/Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey., Gothard D; Biostats, Inc., East Canton, OH, USA., Shauver L; Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA., Clark J; The Heart Center, Akron Children's Hospital, Akron, OH, USA.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2023 May; Vol. 33 (5), pp. 754-759. Date of Electronic Publication: 2022 Jun 08.
DOI:	10.1017/S1047951122001676
Abstrakt:	Background: Electroanatomic mapping systems are increasingly used during ablations to decrease the need for fluoroscopy and therefore radiation exposure. For left-sided arrhythmias, transseptal puncture is a common procedure performed to gain access to the left side of the heart. We aimed to demonstrate the radiation exposure associated with transseptal puncture. Methods: Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry. Patients with left-sided accessory pathway-mediated tachycardia, with a structurally normal heart, who had a transseptal puncture, and were under 22 years of age were included. Those with previous ablations, concurrent diagnostic or interventional catheterisation, and missing data for fluoroscopy use or procedural outcomes were excluded. Patients with a patent foramen ovale who did not have a transseptal puncture were selected as the control group using the same criteria. Procedural outcomes were compared between the two groups. Results: There were 284 patients in the transseptal puncture group and 70 in the patent foramen ovale group. The transseptal puncture group had a significantly higher mean procedure time (158.8 versus 131.4 minutes, p = 0.002), rate of fluoroscopy use (38% versus 7%, p < 0.001), and mean fluoroscopy time (2.4 versus 0.6 minutes, p < 0.001). The acute success and complication rates were similar. Conclusions: Performing transseptal puncture remains a common reason to utilise fluoroscopy in the era of non-fluoroscopic ablation. Better tools are needed to make non-fluoroscopic transseptal puncture more feasible.
Databáze:	MEDLINE
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