A 3D nonfluoroscopic navigation system for pulmonary vein isolation significantly reduced mean fluoroscopy exposure (22 vs 56 minutes, P<0.05) compared to conventional fluoroscopy.
RCT (n=60)
Does a 3D nonfluoroscopic navigation system reduce fluoroscopy and radiofrequency delivery times compared to conventional fluoroscopy in patients undergoing pulmonary vein isolation for atrial fibrillation?
A 3D nonfluoroscopic navigation system for atrial fibrillation ablation significantly reduces fluoroscopy and radiofrequency delivery times compared to conventional fluoroscopy, albeit with longer initial procedural times.
Absolute Event Rate: 22% vs 56%
p-value: p=<0.05
Different techniques have been proposed to treat atrial fibrillation (AF) by catheter ablation. This study compares a new three-dimensional (3D) nonfluoroscopic navigation system with conventional fluoroscopy to guide pulmonary vein (PV) isolation. A total of 60 consecutive patients with paroxysmal or persistent AF were randomly assigned to 3D-guided ablation (group 1, n = 30), versus conventional fluoroscopy guidance ablation (group 2, n = 30). Complete PV isolation was achieved in both groups. The mean duration of fluoroscopy exposure (22 +/- 8 vs 56 +/- 10 minutes), and radiofrequency delivery (5 +/- 1 vs 10 +/- 3 minutes) were significantly shorter in group 1 than in group 2, P < 0.05 for both comparisons). The mean procedural time in group 1 was longer (225 +/- 15 minutes) than in group 2 (156 +/- 10 minutes, P < 0.05) due to the learning curve and time spent to generate the 3D maps. Over a mean follow-up of 7 +/- 2 months, 6 patients (20%) in group 2 had AF recurrences compared to 3 patients (10%) in group 1 (ns). The new nonfluoroscopic 3D system allows a high-resolution reconstruction of the left atrium and PVs. It significantly reduces the mean radiofrequency delivery and fluoroscopy times as opposed to ablation performed under fluoroscopy guidance.
Tondo et al. (Sat,) conducted a rct in Atrial fibrillation (n=60). 3D nonfluoroscopic navigation system vs. Conventional fluoroscopy guidance was evaluated on Mean duration of fluoroscopy exposure (minutes) (p=<0.05). A 3D nonfluoroscopic navigation system for pulmonary vein isolation significantly reduced mean fluoroscopy exposure (22 vs 56 minutes, P<0.05) compared to conventional fluoroscopy.
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