Use of a visualizable steerable sheath during catheter ablation for atrial fibrillation significantly reduced median fluoroscopy time (3.4 vs. 5.8 min; P=0.003) compared with a non-visualizable sheath.
Observational (n=91)
No
Does a visualizable steerable sheath reduce radiation exposure and procedure times compared to a non-visualizable sheath during catheter ablation for atrial fibrillation?
The use of a visualizable steerable sheath during AF ablation significantly reduces radiation exposure without increasing overall procedure time.
Absolute Event Rate: 3.4% vs 5.8%
p-value: p=0.003
AIMS: Incorporating a steerable sheath that can be visualized using an electroanatomical mapping (EAM) system may allow for more efficient mapping and catheter placement, while reducing radiation exposure, during ablation procedures for atrial fibrillation (AF). This study evaluated fluoroscopy usage and procedure times when a visualizable steerable sheath was used compared with a non-visualizable steerable sheath for catheter ablation for AF. METHODS AND RESULTS: In this retrospective, observational, single-centre study, patients underwent catheter ablation for AF using a steerable sheath that is visualizable using the CARTO EAM (VIZIGO; n = 57) or a non-visualizable steerable sheath (n = 34). The acute procedural success rate was 100%, with no acute complications in either group. Use of the visualizable sheath vs. the non-visualizable sheath was associated with a significantly shorter fluoroscopy time median (first quartile, third quartile), 3.4 (2.1, 5.4) vs. 5.8 (3.8, 8.6) min; P = 0.003, significantly lower fluoroscopy dose 10.0 (5.0, 20.0) vs. 18.5 (12.3, 34.0) mGy; P = 0.015, and significantly lower dose area product 93.0 (48.0, 197.9) vs. 182.2 (124.5, 355.0) μGy·m2; P = 0.017 but with a significantly longer mapping time 12.0 (9.0, 15.0) vs. 9.0 (7.0, 11.0) min; P = 0.004. There was no significant difference between the visualizable and non-visualizable sheaths in skin-to-skin time 72.0 (60.0, 82.0) vs. 72.0 (55.5, 80.8) min; P = 0.623. CONCLUSION: In this retrospective study, use of a visualizable steerable sheath for catheter ablation of AF significantly reduced radiation exposure vs. a non-visualizable steerable sheath. Although mapping time was longer with the visualizable sheath, the overall procedure time was not increased.
Fitzpatrick et al. (Thu,) conducted a observational in Atrial fibrillation (n=91). Visualizable steerable sheath (VIZIGO) vs. Non-visualizable steerable sheath was evaluated on Fluoroscopy time (minutes) (p=0.003). Use of a visualizable steerable sheath during catheter ablation for atrial fibrillation significantly reduced median fluoroscopy time (3.4 vs. 5.8 min; P=0.003) compared with a non-visualizable sheath.