Near-zero or zero fluoroscopic procedures using advanced imaging tools are as safe and effective as traditional fluoroscopy-guided approaches for the ablation of various cardiac arrhythmias.
Do fluoroless or minimal-fluoroscopy approaches reduce radiation exposure without compromising safety and efficacy in patients undergoing EP procedures?
Fluoroless EP procedures using advanced imaging technologies are feasible and safe, offering a way to eliminate radiation exposure for patients and operators.
In the past decade, the use of interventional electrophysiological (EP) procedures for the diagnosis and treatment of cardiac arrhythmias has exponentially increased. These procedures usually require fluoroscopy to guide the advancement and frequent repositioning of intracardiac catheters, resulting in both the patient and the operator being subjected to a considerable degree of radiation exposure. Although shielding options such as lead gowns, glasses, and pull-down shields are useful for protecting the operator, they do not lessen the patient's level of exposure. Furthermore, the prolonged use of lead gowns can exponentiate the onset of orthopedic problems among operators. Recent advancements in three-dimensional cardiac mapping systems and the use of radiation-free imaging technologies such as magnetic resonance imaging and intracardiac ultrasound allow operators to perform EP procedures with minimal or even no fluoroscopy. In this review, we sought to describe the state of fluoroless procedures in EP practice.
Canpolat et al. (Sun,) conducted a review in Cardiac arrhythmias. Fluoroless or minimal-fluoroscopy procedures vs. Conventional fluoroscopy-guided procedures was evaluated. Near-zero or zero fluoroscopic procedures using advanced imaging tools are as safe and effective as traditional fluoroscopy-guided approaches for the ablation of various cardiac arrhythmias.