A Zero-Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems

2014 ◽  
Vol 37 (8) ◽  
pp. 1029-1037 ◽  
Author(s):  
ROSA MACÍAS ◽  
INÉS URIBE ◽  
LUIS TERCEDOR ◽  
JUAN JIMÉNEZ-JÁIMEZ ◽  
TERESA BARRIO ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Catheter Ablation ◽  
Electroanatomical Mapping ◽  
Cavotricuspid Isthmus ◽  
Mapping Systems ◽  
Zero Fluoroscopy

scholarly journals Study on the Curative Effect and Safety of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation via Zero-Fluoroscopy Transseptal Puncture under the Dual Guidance of Electroanatomical Mapping and Intracardiac Echocardiography

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Fei Hang ◽  
Liting Cheng ◽  
Zhuo Liang ◽  
Ruiqing Dong ◽  
Xinlu Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Intracardiac Echocardiography ◽  
Transseptal Puncture ◽  
Electroanatomical Mapping ◽  
Curative Effect ◽  
Significant Difference ◽  
Zero Fluoroscopy

Aims. 3D electroanatomical mapping combined with intracardiac echocardiography- (EAM-ICE-) guided transseptal puncture has been proven safe and effective during the radiofrequency catheter ablation (RFCA) procedure used to treat paroxysmal atrial fibrillation (PAF). In this study, we aimed to compare the curative effect and safety of RFCA via F (fluoroscopy) and zero-fluoroscopy transseptal puncture guided by EAM-ICE in patients with PAF. Methods and Results. A prospective study in which 110 patients with PAF were included and assigned to two groups was conducted. Fifty-five (50%) patients were enrolled in the EAM-ICE group, whereas the other 55 (50%) patients were enrolled in the F group. There were no significant differences in baseline characteristics between the two groups. The transseptal duration time was longer in the EAM-ICE group (19.8 ± 3.0 min vs. 8.6 ± 1.2 min, p ≤ 0.01 ); however, fluoroscopy was not used in the EAM-ICE group compared with the F group (0 mGy vs. 109.1 ± 57.9 mGy). Similarly, there was also no significant difference in the recurrence rate of atrial fibrillation between the EAM-ICE and F groups (25.5% vs. 18.2%, p = 0.356 ). Conclusion. RFCA via EAM-ICE-guided zero-fluoroscopy transseptal puncture in patients with PAF is safe and effective for long-term follow-up.

scholarly journals Fluoroless Catheter Ablation of Cardiac Arrhythmias

2018 ◽  
Vol 12 (2) ◽  
pp. 107
Author(s):  
Sandeep K Goyal ◽  
Bruce S Stambler ◽  
◽  
Keyword(s):  
Catheter Ablation ◽  
Ionizing Radiation ◽  
Health Risks ◽  
Cardiac Arrhythmias ◽  
Intracardiac Echocardiography ◽  
Protective Equipment ◽  
3D Mapping ◽  
Mapping Systems ◽  
Zero Fluoroscopy ◽  
Arrhythmia Management

Catheter ablation is the mainstay of cardiac arrhythmia management, and the number of these procedures carried out is continuing to grow. Fluoroscopy has been integral to these procedures to ensure safe catheter manipulation. Unfortunately, exposure to ionizing radiation is associated with several health risks to patients and personnel. The personal protective equipment used to reduce these risks is associated with incomplete protection and orthopedic risks to physicians and other staff. 3D mapping systems and intracardiac echocardiography, if used properly, can significantly reduce the use of fluoroscopy. The study describes a zero-fluoroscopy approach to cardiac ablation of AF and other arrhythmias using 3D mapping and intracardiac echocardiography to reduce or eliminate exposure to ionizing radiation and orthopedic risks to personnel.

scholarly journals 178 Catheter inversion during cavotricuspid isthmus catheter ablation: the new shaft visualization catheter reduces fluoroscopy use

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Nicolò Sisti ◽  
Amato Santoro ◽  
Claudia Baiocchi
Keyword(s):  
Catheter Ablation ◽  
Atrial Flutter ◽  
Linear Correlation ◽  
Procedure Time ◽  
Ablation Catheter ◽  
Anatomical Characteristics ◽  
Cavotricuspid Isthmus ◽  
Group 2 ◽  
Zero Fluoroscopy ◽  
Group 1

Abstract Aims Catheter ablation (CA) is the choice therapy of cavotricuspid isthmus (CTI) atrial flutter. The aim of this study was to describe our approach to improve the CTI ablation using a zero-fluoroscopy (ZF). The procedural difficulties could be related to anatomical characteristics of the CTI. Methods and results One hundred eighty-eight patients that performed CA of CTI were retrospectively and consecutively evaluated between 2017 and 2019. The studied population was divided into two groups. Eighty-eight patients who were undergone CA using ablation catheter without shaft visualization catheter (NSV) were Group 1. One hundred patients were undergone CA using ablation catheter with a shaft visualization (SV); they were Group 2. The catheter was looped at the Eustachian ridge after 200 s of radiofrequencies (RF) without elimination of local electrogram. A conduction line block of CTI was obtained in all patients of Group 2 using a ZF approach. In 16 patients of Group 1, the catheter inversion was obtained using fluoroscopy to avoid damages during its loop. In Group 2, a complete CTI block was obtained with a catheter inversion approach in 10 patients without fluoroscopy, visualizing the shaft and the tip of the ablation catheter on the electroanatomic (EAM) map. In the overall population studied the use of SV had a linear correlation with the ZF approach (r = 0.629; P < 0.001). The duration of RF was lower in Group 2 than in Group 1 (Group 1: 27.8 ± 6.3 vs. Group 2: 15.6 ± 7.2 min; P < 0.01). The procedure time between two groups was lower in Group 2 than in Group 1 (Group 1: 58.4 ± 22.4 vs. Group 2: 42.2 ± 15.7 min; P < 0.01). No differences between two groups were documented regarding success and complications. Conclusions The visualization of the shaft’s catheter on the EAM permitted the catheter inversion safely in order to overcome some complex CTI anatomy and obtain bidirectional block. The SV reduced procedure time, RF applications, and fluoroscopy exposition during CTI ablation.

Electroanatomical mapping systems in catheter ablation of cardiac arrhythmias

2008 ◽  
Vol 149 (25) ◽  
pp. 1155-1160 ◽  
Author(s):  
Attila Mihálcz ◽  
Tamás Tahin ◽  
Tamás Szili-Török
Keyword(s):  
Catheter Ablation ◽  
Real Time ◽  
Cardiac Arrhythmias ◽  
Electroanatomical Mapping ◽  
Time Position ◽  
Position Management ◽  
Mapping Systems

Az utóbbi években a folyamatos technikai fejlesztéseknek köszönhetően az elektrofiziológiai szívlaborokban megjelentek az elektroanatómiai térképező rendszerek, melyek segítségével precízen jellemezhetők a ritmuszavar alapjául szolgáló anatómiai struktúrák, és könnyen reprodukálhatók egy adott szívüreg aktivációs folyamatai. Lehetővé vált a ritmuszavar kialakulásához szükséges élettani folyamatok megértése, és ezáltal pontosan meghatározható a tervezett intervenció térbeli helye. Az utóbbi években a képi diagnosztikai módszerek rohamos fejlődésének köszönhetően a ritmuszavarok anatómiai szubsztrátjának képi megjelenítése és az anatómiavezérelt katéterablatio került előtérbe. Jelenleg több térképező technológia áll rendelkezésünkre: Carto XP, Ensite NavX és Array, Real-time Position Management. A jelen közleményünkben röviden áttekintjük a felsorolt elektroanatómiai térképező rendszerek működési elveit, külön ismertetve egyes rendszerek előnyeit és hátrányait. A gyakorlati alkalmazások mellett elméleti lehetőségekkel is foglalkozunk, hiszen a jövő rendszerei, az aktivációs idők és feszültségek mellett, egy sor egyéb fiziológiai paramétert regisztrálnak majd, és képesek lesznek azokat elemezni, egyre tökéletesebb anatómiai megjelenítésben. Az új technológiák bevezetésének köszönhetően a katéterablatiós terápiás beavatkozások a ritmuszavarok széles spektrumánál sikeresen alkalmazhatók. Segítségükkel az atípusos flutter, a kamrai tachycardiák, a congenitalis vitiumok műtéti megoldását követő ritmuszavarok és a pitvarfibrilláció katéterablatiós kezelése rutinfeladattá vált. A technológiai újítások érdeme megkérdőjelezhetetlen, ám a terápiás és a költséghatékonyság mérlegelése további kérdéseket vet fel.

scholarly journals Comparative Use of Upgraded and Conventional Electroanatomical Mapping Systems for Atrial Fibrillation Catheter Ablation

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PE4_022
Author(s):  
Masahiro Esato ◽  
Yoshitomi Kida ◽  
Naoto Nishina ◽  
Yeonghwa Chun
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Electroanatomical Mapping ◽  
Mapping Systems

Success radiofrequent catheter ablation of cavotricuspid isthmus with the help of jugular and subclavian approach

2019 ◽  
Vol 16 (2) ◽  
pp. 92-95
Author(s):  
A.A. Saparbaev ◽  
◽  
A.G. Filatov ◽  
I.A. Temirbulatov ◽  
Z.F. Fatulaev
Keyword(s):  
Catheter Ablation ◽  
Cavotricuspid Isthmus

scholarly journals Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use

2021 ◽  
Author(s):  
Amato Santoro ◽  
Claudia Baiocchi ◽  
Nicolò Sisti ◽  
Valerio Zacà ◽  
Carlo Renato Pondrelli ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Cavotricuspid Isthmus

scholarly journals P-271 Occurence of atrial fibrillation after catheter ablation of the cavotricuspid isthmus: Long-term outcome

EP Europace ◽  
2003 ◽  
Vol 4 (Supplement_2) ◽  
pp. B130-B130
Author(s):  
H. Mlcochova ◽  
R. Cihak ◽  
J. Kautzner ◽  
J. Bytesnik ◽  
V. Vancura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cavotricuspid Isthmus
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