Zero-fluoroscopy catheter ablation demonstrated no significant difference in acute procedural success compared to conventional fluoroscopy for ventricular arrhythmia (RR 1.01, p=0.69).
Meta-Analysis (n=1,408)
Does zero-fluoroscopy catheter ablation improve acute procedural success and safety compared to non-zero fluoroscopy in patients undergoing ablation for ventricular arrhythmia?
Zero-fluoroscopy catheter ablation is a safe and effective alternative to conventional fluoroscopy for ventricular arrhythmias, eliminating radiation exposure without compromising procedural success.
Relative Risk: 1.01 (95% CI 0.95–1.07)
p-value: p=0.69
Catheter ablation has been the go-to treatment for ventricular arrhythmia, with traditional fluoroscopy-guided and non-zero fluoroscopy (NZF) catheter ablation posing high radiation risk for operators and patients. Zero-fluoroscopy technique offers elimination of radiation risk; however, its efficacy and safety in ventricular arrhythmia patients are not well explored. The aim of this study was to systematically evaluate the effectiveness, safety, and feasibility of zero-fluoroscopy ablation on ventricular arrhythmia patients. This study only included relevant studies comparing zero-fluoroscopy and NZF in ventricular arrhythmia ablation that were identified from Scopus, PubMed, and ScienceDirect (up to June 20, 2024). The quality of the study was assessed using the ROBINS-I tool, and the meta-analysis was conducted using a random-effect model. Out of 383 studies found, nine cohort studies were included with 1.408 patients. There was no significant difference in the acute procedural success rate of the zero-fluoroscopy and NZF (relative risk: 1.01; 95%CI: 0.95–1.07; p=0.69), with a similar recurrence rate (p=0.88; for four studies; n=374), and comparable procedural time (mean difference: -19.22 minutes; 95%CI: -41.16–2.72; p=0.09). Adverse events such as pericardial effusion, pseudoaneurysm, and hematoma were similar between zero-fluoroscopy and NZF. Overall, zero-fluoroscopy catheter ablation has demonstrated non-inferiority as a treatment option for ventricular arrhythmia ablation. As zero-fluoroscopy eliminates radiation risk without compromising procedural efficacy, zero-fluoroscopy has the potential to become a widely adopted approach for catheter ablation in ventricular arrhythmia.
Irnizarifka et al. (Thu,) conducted a meta-analysis in Ventricular arrhythmia (n=1,408). Zero-fluoroscopy catheter ablation vs. Non-zero fluoroscopy (NZF) catheter ablation was evaluated on Acute procedural success rate (RR 1.01, 95% CI 0.95-1.07, p=0.69). Zero-fluoroscopy catheter ablation demonstrated no significant difference in acute procedural success compared to conventional fluoroscopy for ventricular arrhythmia (RR 1.01, p=0.69).