Abstract 18165: Fluoroscopic-Free Ablation with 3D Imaging: Immediate Procedural Success and Complications
Introduction: Ablation is a curative procedure for many supra-ventricular tachycardia’s. Classically, fluoroscopic imaging has been used to guide catheter placement and ablation. Prolonged radiation exposure from complicated or repeat ablation may increase the lifetime risk of cancer through stochastic effects, particularly in young patients and healthcare providers. In addition, protective lead aprons and vests required for healthcare providers and can result in physical injury from extended, repeated use. Use of 3D electro-anatomical navigation systems has significantly reduced the amount of fluoroscopy used for ablation. We extended this further by using of 3D navigation systems in a complete fluoro-free (FF) ablation. Here, we report safety and efficacy of this technique in a large patient cohort.
Methods: From February, 2010 - March, 2013 all ablations performed FF at a single academic medical center were enrolled in an ablation registry. Patient and procedural characteristics for each ablation were collected. We report the ablation characteristics, acute procedural success, and complication rate associated with FF ablation.
Results: During the study period, 102 consecutive ablations by two operators were performed with the intention of FF. 14 of 102 cases required fluoro guidance at the discretion of the operator (13.7% cross-over). The average patient age was 22.1 years, 49% were male. The 2 most common diagnoses for FF ablation were AVNRT (58.4%) and AVRT (24.8%). Of the 88 FF cases, the acute procedural success rate was 97%. 77.9% were performed with cryoablation. 4.6% of FF cases suffered minor complications including: 2 with transient heart block, 1 groin hematoma managed conservatively, and 1 transient prolongation of the AH interval. There were no cases of permanent heart block. There were no significant complications in the FF group.
Conclusions: Ablation of supra-ventricular tacharrhythmias without use of fluoroscopy has a high acute procedural success rate with low incidence of procedural complication. Use of this technique completely relieves the patient and healthcare of radiation exposure, eliminating radiation stochastic effects and obviating the need for protective shielding.
Author Disclosures: R.T. Kipp: None. J.A. Oujiri: None. J. Boynton: None. N. Von Bergen: None. L. Eckhardt: None.
- © 2014 by American Heart Association, Inc.