Nonfluoroscopic catheter ablation of paroxysmal atrial fibrillation

Autor:	Alexander Klukvin, Ayan Abdrahmanov, S. Mironovich, Valery Marinin, Alexander Morozov, Azat Tursunbekov, Abay Bakytzhanuly, Evgeny Lyan, Roland Richard Tilz, Noureddin Sawan, Alexey Tsyganov, Omirbek Nuralinov
Rok vydání:	2018
Předmět:	Epicardial Mapping Male Safety Management medicine.medical_treatment Operative Time Catheter ablation 030204 cardiovascular system & hematology Intracardiac injection Pulmonary vein 03 medical and health sciences 0302 clinical medicine Cardiac tamponade Atrial Fibrillation medicine Humans Fluoroscopy 030212 general & internal medicine Retrospective Studies medicine.diagnostic_test business.industry Atrial fibrillation General Medicine Middle Aged Radiation Exposure medicine.disease Ablation Treatment Outcome Angiography Catheter Ablation Female Cardiology and Cardiovascular Medicine Nuclear medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 41:611-619
ISSN:	0147-8389
Popis:	AIMS Radiofrequency catheter ablation of atrial fibrillation (AF) is one of the most complex ablation procedures. Both patients and operators are exposed to scattered radiation. This study evaluated the safety and efficacy of intracardiac echo (ICE)-guided pulmonary vein isolation (PVI) without fluoroscopy. METHODS We retrospectively analyzed the data of 481 consecutive patients with paroxysmal AF undergoing radiofrequency PVI with the CARTO 3 system (Biosense Webster, Diamond Bar, CA, USA). ICE-guided PVI without fluoroscopy and without CT/MRI integration (Nonfluoro group) was performed for 245 patients, and conventional fluoroscopy-guided PVI (Fluoro group) was performed for 236 patients. The primary safety endpoint was the incidence of major adverse events. The primary efficacy endpoint was freedom from AF during follow-up. Secondary endpoints included procedure duration, fluoroscopy duration, and acute PVI rate. RESULTS Mean procedure times between groups were similar (108.8 ± 18.2 minutes in the Non-fluoro group vs 113.6 ± 26.8 minutes in the Fluoro group; P = not significant [NS]). Acute PVI was achieved in all patients, with mean radiofrequency application times of 43.4 ± 7.5 and 44.4 ± 10.7 minutes for the Nonfluoro and Fluoro groups, respectively (P = NS). The incidence of cardiac tamponade was 1.2% (3/245 patients) in the Nonfluoro group and 0.8% (2/236 patients) in the Fluoro group (P = NS). During 15.2 ± 4.1 months of follow-up, after a single procedure, AF recurrence was documented in 65 of 245 (26.5%) patients and 61 of 236 (25.8%) patients in the Nonfluoro and Fluoro groups, respectively (P = NS). CONCLUSIONS Nonfluoroscopic ICE-guided catheter ablation of AF without prior cardiac image integration or angiography is feasible and safe. PVI without fluoroscopy did not affect procedure duration or long-term efficacy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c05b029d9506af1fa490a3fb5cc45a44 https://doi.org/10.1111/pace.13321 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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