Key result
Visualizable steerable sheaths cut fluoroscopy time ~41% vs. non-visualizable sheaths in AF ablation.
Why the study?
Visualizing a steerable sheath with an electroanatomical mapping system may improve mapping efficiency and catheter placement while lowering radiation during AF ablation, but comparative data were needed.
Does the use of a visualizable steerable sheath reduce radiation exposure and procedure times compared to a non-visualizable steerable sheath in patients undergoing catheter ablation for atrial fibrillation?
Cohort (n=91)
No
Does the use of a visualizable steerable sheath reduce radiation exposure and procedure times compared to a non-visualizable steerable sheath in patients undergoing catheter ablation for atrial fibrillation?
Integrating a visualizable steerable sheath into AF ablation procedures meaningfully reduces procedural radiation exposure to patients and staff without prolonging the overall procedure duration.
May lower radiation exposure in AF ablation; leaves open confirmation in randomized trials before practice change.
AIMS: Incorporating a steerable sheath that can be visualized using an electroanatomical mapping (EAM) system may allow for more efficient mapping and catheter placement, while reducing radiation exposure, during ablation procedures for atrial fibrillation (AF). This study evaluated fluoroscopy usage and procedure times when a visualizable steerable sheath was used compared with a non-visualizable steerable sheath for catheter ablation for AF. METHODS AND RESULTS: In this retrospective, observational, single-centre study, patients underwent catheter ablation for AF using a steerable sheath that is visualizable using the CARTO EAM (VIZIGO; n = 57) or a non-visualizable steerable sheath (n = 34). The acute procedural success rate was 100%, with no acute complications in either group. Use of the visualizable sheath vs. the non-visualizable sheath was associated with a significantly shorter fluoroscopy time [median (first quartile, third quartile), 3.4 (2.1, 5.4) vs. 5.8 (3.8, 8.6) min; P = 0.003], significantly lower fluoroscopy dose [10.0 (5.0, 20.0) vs. 18.5 (12.3, 34.0) mGy; P = 0.015], and significantly lower dose area product [93.0 (48.0, 197.9) vs. 182.2 (124.5, 355.0) μGy·m2; P = 0.017] but with a significantly longer mapping time [12.0 (9.0, 15.0) vs. 9.0 (7.0, 11.0) min; P = 0.004]. There was no significant difference between the visualizable and non-visualizable sheaths in skin-to-skin time [72.0 (60.0, 82.0) vs. 72.0 (55.5, 80.8) min; P = 0.623]. CONCLUSION: In this retrospective study, use of a visualizable steerable sheath for catheter ablation of AF significantly reduced radiation exposure vs. a non-visualizable steerable sheath. Although mapping time was longer with the visualizable sheath, the overall procedure time was not increased.
No takes yet. Share an insight, caveat, or question.
Fitzpatrick et al. (2023) conducted a cohort in Atrial fibrillation (n=91). Visualizable steerable sheath (VIZIGO) vs. Non-visualizable steerable sheath (Agilis) was evaluated on Fluoroscopy time (p=0.003). Use of a visualizable steerable sheath significantly reduced median fluoroscopy time compared to a non-visualizable steerable sheath (3.4 vs 5.8 min, P=0.003) during catheter ablation for atrial fibrillation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: