Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta-analysis.

Autor: Luke K; Faculty of Medicine Universitas Airlangga Surabaya Indonesia., Milla C; Faculty of Medicine Universitas Airlangga Surabaya Indonesia., Tandi JK; Faculty of Medicine Universitas Tarumanagara Jakarta Indonesia., Julario R; Department of Cardiology and Vascular Medicine Dr. Soetomo General Hospital-Universitas Airlangga Surabaya Indonesia.
Jazyk: angličtina
Zdroj: Journal of arrhythmia [J Arrhythm] 2023 Nov 15; Vol. 40 (1), pp. 38-46. Date of Electronic Publication: 2023 Nov 15 (Print Publication: 2024).
DOI: 10.1002/joa3.12949
Abstrakt: Background: Fluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults.
Method: A systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non-English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach.
Results: Seven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33-4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: -0.35 to 0.55 and SMD: -0.71, 95% CI: -1.87-0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: -1.80, 95% CI: -2.49 to -1.12 and SMD: -1.26, 95% CI: -2.24 to -0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41-2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20-0.59).
Conclusion: ZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure.
Competing Interests: Authors declare no conflict of interests for this article.
(© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
Databáze: MEDLINE
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