Subject(s)
Cardiac Complexes, Premature/surgery , Fibroma/complications , Fibroma/surgery , Heart Neoplasms/complications , Heart Neoplasms/surgery , Heart Ventricles/surgery , Tachycardia, Ventricular/surgery , Cardiac Complexes, Premature/diagnostic imaging , Child , Echocardiography , Electrocardiography, Ambulatory , Fibroma/diagnostic imaging , Follow-Up Studies , Heart Neoplasms/diagnostic imaging , Heart Ventricles/diagnostic imaging , Humans , Image Enhancement , Magnetic Resonance Imaging , Male , Neoplasm, Residual/diagnosis , Papillary Muscles/surgery , Postoperative Complications/diagnosis , Tachycardia, Ventricular/diagnostic imagingABSTRACT
BACKGROUND: Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. Widespread use of zero-fluoroscopic catheter ablation in clinical routine is limited by safety concerns. This study investigated the feasibility of zero-fluoroscopy catheter ablation using a three-dimensional mapping system and optional catheter contact force technology for an all-comers collective. PATIENTS AND METHODS: The study comprised 184 patients; 91 patients, including 29 pediatric patients, underwent a zero-fluoroscopic electrophysiology (EP) study using the EnSite NavX system with real-time visualization of all electrodes. These patients were matched to a control group, which was treated using fluoroscopy in the same period. Inclusion criteria were documented supraventricular tachycardia or a history of symptomatic paroxysmal supraventricular tachycardia. Transseptal access, if necessary, was achieved under transesophageal echocardiographic guidance for ablation of left-sided arrhythmias. Radiofrequency (using optional contact force measurement) or a cryotechnique was used for ablation. RESULTS: We observed no major acute complications. There were no significant differences between the two groups in the follow-up period. CONCLUSION: Zero-fluoroscopic catheter ablation is generally feasible in right-sided cardiac arrhythmias. Safety concerns regarding left atrial substrates or children can be overcome with optional real-time contact force measurement.