Key result
Zero-fluoroscopy ablation for right-sided arrhythmias is linked to ~17 minutes shorter procedure time vs. conventional fluoroscopy.
Why the study?
Fluoroscopy carries long-term health risks, prompting evaluation of a zero-fluoroscopy approach using only electroanatomic mapping without additional invasive procedures for right-sided cardiac arrhythmias.
Does a zero-fluoroscopy approach using only electroanatomic mapping improve efficiency and maintain safety compared to conventional fluoroscopy in patients with right-sided cardiac arrhythmias?
Cohort (n=328)
No
Does a zero-fluoroscopy approach using only electroanatomic mapping improve efficiency and maintain safety compared to conventional fluoroscopy in patients with right-sided cardiac arrhythmias?
Absolute Event Rate: 70% vs 87%
p-value: p=0.0001
A zero-fluoroscopy approach using only electroanatomic mapping for right-sided arrhythmias is feasible, safe, and reduces procedure time compared to conventional fluoroscopy.
Zero-fluoroscopy mapping was associated with shorter right-sided ablation times and similar success; hypothesis-generating and requires randomized confirmation before practice change.
INTRODUCTION: Fluoroscopy is traditionally used for catheter interventions in electrophysiology but carries a long-term health risk. Besides additional invasive procedures to achieve zero-fluoroscopy (ZF) interventions, electroanatomic mapping may be an alternative to fluoroscopy without the need of additional procedures. We aimed to investigate the feasibility, safety, and efficiency of a ZF approach using only electroanatomic mapping (ZF) compared to a conventional fluoroscopic (CF) approach for patients with right sided cardiac arrhythmias. METHODS: We performed a single centre retrospective cohort study of consecutive patients undergoing catheter interventions for electrophysiologic procedures from January 2019 to December 2020. Patients with left-sided arrhythmias, focal cryoablation, implanted endocardial devices, or additional interventions requiring fluoroscopy were excluded. RESULTS: 202 patients underwent a ZF and 126 patients underwent a CF approach for right-sided cardiac arrhythmias. Apart from atrial fibrillation (ZF 16% vs. CF 9%, p = 0.044), baseline demographics were similar in both groups. Acute success rate was 100% in the ZF group and 97.9% in the CF group. Mean procedure time was lower in the ZF group (70 ± 36 vs. 87 ± 44 min, p = 0.0001), while ablation time (356 ± 324 vs. 320 ± 294 s, p = 0.157) was similar. Total complication rate was low in general (1.0 % major, 2% minor complications) and without a difference between both groups. CONCLUSION: A ZF approach using only electroanatomic mapping without additional invasive procedures to diagnose and treat right-sided cardiac arrhythmias is feasible, efficient, and safe.
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Höfer et al. (2022) conducted a cohort in Right-sided cardiac arrhythmias (n=328). Zero-fluoroscopy approach using electroanatomic mapping vs. Conventional fluoroscopic approach was evaluated on Mean procedure time (minutes) (p=0.0001). A zero-fluoroscopy approach for right-sided cardiac arrhythmias significantly reduced mean procedure time (70 vs 87 min, p=0.0001) compared to conventional fluoroscopy with similar acute success.
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