Non-fluoroscopic catheter ablation: A randomized trial

Figures

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  Fig. 1. Positioning of the catheters during ablation of nodal reetrant tachycardia. Left image (right anterior oblique view) shows catheter shadow with right bundle branch identification and His bundle region. It should be noted that the potential of His was identified in a region up to 1 cm in height. In the right image (left anterior oblique view), we note this fact, where we observed three levels of His, one more caudal, another intermediate and another more cranial. In part this may be due to the movement of the heart and the modification of the chest impedance during deep inspiration. However, it is important to clearly delineate this region to perform a safe application of radiofrequency. The structure in lilac is the coronary sinus. The blue spot (near the entrance of the coronary sinus) demonstrates a place where we obtained slow junctional rhythm. In red are other regions where the application of energy (15 s) did not trigger slow junctional rhythm.

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  Fig. 2. Recording of supraventricular tachycardia initiated with the introduction of atrial extrastimuli at an earlier age. A VA interval <60 ms is observed during tachycardia and concentric retrograde atrial activation.

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  Fig. 3. Left lateral bundle ablation during tachyarrhythmia due to atrioventricular reentry. Left (right anterior oblique view) and right (left anterior oblique view) images show shade of the catheters with identification of the His bundle, coronary sinus, and ablation catheter. The ablation catheter was introduced by the aorta retrograde. In brown, two points with precocity are observed where radiofrequency energy applications were performed for 10 s, without ending the arrhythmia. The dot marked in red demonstrates the site of greater precocity of VA signal during tachyarrhythmia, observed in the endocavitary tracing below the figures. After 7.6 s of radiofrequency energy application, the arrhythmia was terminated. After this application, no further induction was possible.