The non-fluoroscopic navigation reduces significantly not only the fluoroscopic exposure during catheter ablation of the cavotricuspid isthmus but the total radiofrequency time as well

Objective The non-fluoroscopic navigation (NFN) is known to reduce the fluoroscopic time during catheter ablation of various arrhythmias. We aimed to study the impact of NFN over several procedural parameters during radiofrequency (RF) catheter ablation of the cavo-tricuspid isthmus (CTI) in patients with CTI-dependent atrial flutter.Methods Data about 124 consecutive patients with CTI ablation performed were retrospectively collected. The patients were divided into two groups: (1) ablation with two diagnostic catheters deployed in the coronary sinus and around the tricuspid annulus (NFN–, n = 62); (2) ablation with the same two catheters plus NFN system using cutaneous patches (NFN+, n = 62). Several procedural parameters were analysed. The non-parametric Mann-Whitney test was used for statistical analysis. A P-value <0.05 was considered significant.Results Acute success was achieved in 122 patients (98.4%), recurrences of atrial flutter were observed in 11 patients (8.9%). There were no significant differences between the NFN + and NFN– groups in the procedural duration (169.6 vs 157.6 min) and the recurrences (6.5 vs 11.3%). In the NFN + group the fluoroscopic time was shorter (9.4 vs 16.7 min), DAP was lower (2,128.3 vs 4,129.9 μGy*m2), the total RF time was shorter (1,870.5 vs 2,335.5 sec), Р < 0.05 for all parameters.Conclusions NFN reduces significantly not only the x-ray exposure but the total RF time as well. It does not influence the procedural duration and the recurrence rate. The acute and long-term success of catheter ablation of CTI is high irrespective of the use of NFN.