RESUMO
Objective:To identify the method to reduce X-ray exposure during ablation of atrial fibrillation (AF) by comparing the cryoballoon (CRYO) ablation and remote magnetic navigation (RMN) ablation.Methods:A retrospective analysis was conducted on 144 patients undergoing CRYO ablation (CRYO group) and 121 patients undergoing RMN ablation (RMN group) in our hospital. Entrance surface doses at reference points online, exposure time during procedure and outcomes were analyzed for different types of patients.Results:Compared with the RMN group, the procedure time for the CRYO group significantly decreased [(165.0±23.6), (97.8±18.4) min, t=26.05, P<0.001]. However, the entrance surface dose value [(232.3±130.7), (669.0±387.5) mGy, Z=-12.29, P<0.001] and X-ray exposure time [(8.1±3.1), (23.4±6.2) min, t=-24.57, P<0.001] increased significantly for the CRYO group. No significant difference was found between the two groups in the proportion of maintaining sinus rhythm during follow-up of patients (71.9%, 75.7%, P=0.618). Multiple regression analysis showed that obese patients, patients with non-paroxysmal AF and patients with variant pulmonary veins were associated with an increase in entrance surface dose values in the CRYO group ( t=5.47, 2.23, 3.39, P<0.05). The X-ray exposure time for the three types patients above in the CRYO group also increased ( t=2.87, 3.86, 3.25, P<0.05) in the CRYO group. However, only obese patients in the RMN group had an increase in entrance surface dose value ( Z=-4.15, P<0.001) and no increase in exposure time. For the three types of patients above, there was no significant difference in proportion of maintaining sinus rhythm between the CRYO group and the RMN group during follow-up ( P>0.05). Conclusions:Compared with RMN ablation, the radiation exposure of CRYO AF ablation significantly increased, especially in obese patients, patients with non-paroxysmal AF and patients with pulmonary veins variation. The use of RMN for these types of patients may reduce the radiation exposure without affecting the procedure outcomes.
RESUMO
Objective To compare the X-ray radiation dose from atrial fibrillation (AF) ablation guided by magnetic navigation system (MNS) and manual procedure (CON).Methods 94 AF patients were randomly divided into MNS group (34 cases) and CON group(60 cases).The dose area product (DAP),cumulative radiation dose (CD),fluoroscopy time of patients,the X-ray exposure time and dose of operators were recorded and analyzed.Results The results from the patients in MNS group and CON group were CD values (0.54 ±0.45) and (1.61 ±0.89) Gy (t =2.44,P ＜0.05),DAP values (46.86 ±27.09) and (139.71 ±76.69) Gy·cm2(t =3.89,P ＜0.05) and fluoroscopy time (15.60 ±7.52) and (39.50 ± 8.82) min (t =1.96,P ＜ 0.05),respectively.The X-ray exposure dose in both groups were (22.68 ± 6.87) and (62.74 ± 20.92) μSv (t =2.02,P ＜ 0.05) for operation doctor (19.38 ± 5.64) and (49.42 ± 10.67) μ Sv (t =3.58,P ＜ 0.05) for operation assistant and (18.98 ± 4.99) and (47.77 ± 13.65) μ Sv (t =3.17,P ＜ 0.05) for nurse,respectively.The X-ray exposure time experienced in both groups were (11.48 ±7.59) and (30.50 ±14.82) min (t =2.75,P ＜0.05) for operation doctor,(8.96 ±5.88) and (24.49 ±9.09) min (t =4.20,P ＜0.05) for operation assistant and (8.33 ±6.35) and (22.99 ± 13.36) min(t =2.76,P ＜ 0.05) for nurse,respectively.Conclusions Compared with manual procedure,the MNS applied in AF ablation has the potential to decrease X-ray exposure dose.
