Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation

• Published in: International journal of cardiology. Heart & vasculature 2021-12, Vol.37, p.100896, Article 100896
• Main Authors: Iwasaki, Yu-ki, Fujimoto, Yuhi, Ito-Hagiwara, Kanako, Oka, Eiichiro, Hayashi, Hiroshi, Yamamoto, Teppei, Murata, Hiroshige, Yodogawa, Kenji, Shimizu, Wataru
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; Catheter ablation; Iintracardiac echocardiography; Near-zero fluoroscopy; Original Paper
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2021.100896

Attempting to minimize radiation exposure during catheter ablation of atrial fibrillation (AF) for patients, operators and medical staffs should be performed. This study aimed to investigate the feasibility and safety of a metal interference alert guided septal approach using 3 intracardiac echocardiography viewing positions for near-zero fluoroscopy AF ablation procedures. A total of 668 procedures among 608 consecutive patients with AF (67.2 ± 7.3 years, 408 males) who underwent catheter ablation were retrospectively evaluated and divided into 2 groups, near-zero group (n = 42) and conventional group (n = 595). In the near-zero group, a metal interference alert guided septal approach with 3 different catheter intracardiac echocardiography positions to minimize the fluoroscopy time was applied, and a left atrial access with 2 long sheaths from a single septal puncture without fluoroscopy was successfully achieved in 41 out of 42 cases. The total fluoroscopy time was significantly shorter in the near-zero group than that in the conventional group (0.5 ± 2.0 vs. 21.4 ± 12.9 min p