Procedural outcomes of fluoroless catheter ablation outside the traditional catheterization lab

Autor: Philip C. Smith, John M. Clark, Grace Smith, John R. Lane, Amee M. Bigelow, Neil L. McNinch, Dylan T. Timberlake
Rok vydání: 2016
Předmět:
Male
Tachycardia
Cardiac Catheterization
Operating Rooms
medicine.medical_specialty
Time Factors
Adolescent
Cath lab
medicine.medical_treatment
Operative Time
Action Potentials
Catheter ablation
030204 cardiovascular system & hematology
Radiography
Interventional
Young Adult
03 medical and health sciences
0302 clinical medicine
Heart Rate
Predictive Value of Tests
Physiology (medical)
Tachycardia
Supraventricular
medicine
Humans
Fluoroscopy
Prospective Studies
030212 general & internal medicine
Child
Ohio
Retrospective Studies
medicine.diagnostic_test
business.industry
medicine.disease
Ablation
Surgery
Catheter
Treatment Outcome
Child
Preschool
Catheter Ablation
Patent foramen ovale
Female
Supraventricular tachycardia
medicine.symptom
Electrophysiologic Techniques
Cardiac
Cardiology and Cardiovascular Medicine
business
Echocardiography
Transesophageal
Zdroj: EP Europace. 19:1378-1384
ISSN: 1532-2092
1099-5129
DOI: 10.1093/europace/euw207
Popis: Aims Non-fluoroscopic catheter ablation is becoming routine. In experienced centres, fluoroscopy is rarely required. The use of a traditional catheterization lab (cath lab) may no longer be necessary. We began performing catheter ablations at a paediatric centre outside the traditional cardiac cath lab in 2013. The purpose of this study was to compare procedural features of paediatric catheter ablation performed outside the cath lab to those performed within a cath lab. Methods and results We prospectively looked at patients presenting to the paediatric centre with supraventricular tachycardia (SVT) undergoing catheter ablation outside the cath lab in a standard operating room (OR group). We compared retrospectively to a control group matched for age, type, and location of arrhythmia who had ablations in a traditional cath lab (CL group). Catheter visualization was exclusively by electro-anatomic mapping. Fifty-nine patients with SVT underwent catheter ablation in the OR from October 2013 to December 2015. Thirty-three patients had accessory pathways, 29 were manifest, and 13 of those were left sided. Twenty-six had atrioventricular nodal re-entrant tachycardia. Transseptal puncture with transoesophageal echocardiography guidance was used for 10 left-sided pathways, whereas the other 3 had patent foramen ovales. Procedure time did not differ significantly between groups (OR group mean 131 min, range 57–408; CL group mean 152 min, range 68–376; P = 0.12). Acute success was similar in both groups [OR group: 58/59 (98.3%) and CL group: 57/59 (96.6%)]. There were no major complications in either group. There was no fluoroscopy used in either group. Conclusion Although performing paediatric catheter ablations outside the traditional cath lab is early in our experience, we produced similar outcomes and results without encountering procedural difficulties of performing ablations in a non-conventional setting. Larger multi-centred trials will be essential to determine the feasibility of this practice.
Databáze: OpenAIRE
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