Abstract 14518: Non-Fluoroscopic Catheter Ablation of Cardiac Arrhythmias in Adults Using Electroanatomic Mapping and Intracardiac Echocardiography
Background. Catheter ablation of arrhythmias is traditionally performed under fluoroscopic guidance exposing patients and medical staff to radiation hazard. Additionally, dependence on fluoroscopy limits ablation in pregnant patients. While the feasibility of non-fluoroscopic catheter ablation has been reported in the pediatric population, limited data exist in adults.
Objectives. (1) To examine the safety and efficacy of catheter ablation without fluoroscopy in adults; (2) To compare procedure duration in patients ablated without (Group 1) and with (Group 2) fluoroscopic guidance.
Methods. In Group 1 (n=45), all patients referred to our institution between 12/8/10 and 5/31/11 underwent catheter ablation without fluoroscopic guidance. Intracardiac electrograms and EnSite NavX 3D electroanatomic mapping (EAM) guided catheter position and created cardiac geometry. Intracardiac echocardiography (ICE) guided transseptal puncture, assisted catheter placement, verified ablating catheter location and tissue apposition. Group 2 (n=45) consisted of consecutive patients undergoing catheter ablation between 1/1/10 and 4/30/10 with fluoroscopic guidance. Procedure time, acute success and complications for both groups were compared. All procedures were performed by one operator. SPSS 17 was used for statistical analysis.
Results. Groups 1 and 2 had similar demographics, arrhythmias ablated and comorbidities. Immediate procedural success was 100% for both groups. Total procedure time was not significantly different. Procedure times for specific arrhythmias were similar except for AVRT which was due to the existence of two accessory pathways in a Group 1 patient.
Conclusion. In adults, catheter ablation of a variety of arrhythmias can be safely and effectively performed without fluoroscopy by relying on EAM and ICE. If these techniques can be applied more broadly, a significant reduction in radiation hazard to both patients and staff may be achieved.
- © 2011 by American Heart Association, Inc.