Zero-fluoroscopy approach for ablation of supraventricular tachycardia using the Ensite NavX system: a multicenter experience

• Published in: BMC cardiovascular disorders 2020-02, Vol.20 (1), p.48-10, Article 48
• Main Authors: Chen, Guangzhi, Wang, Yan, Proietti, Riccardo, Wang, Xunzhang, Ouyang, Feifan, Ma, Chang Sheng, Yu, Rong Hui, Zhao, Chunxia, Ma, Kezhong, Qiu, Jie, Liu, Qigong, Wang, Dao Wen
• Format: Article
• Language: English
• Subjects: Ablation (Surgery); Action Potentials; Adult; Arrhythmia; Cardiac arrhythmia; Care and treatment; Catheter Ablation - adverse effects; Catheter Ablation - instrumentation; Catheters; China; Diagnostic imaging; Electrocardiography; Electrodes; Electrophysiologic Techniques, Cardiac - adverse effects; Electrophysiologic Techniques, Cardiac - instrumentation; Female; Fluoroscopy; Heart; Heart Rate; Humans; Ionizing radiation; Male; Methods; Middle Aged; Navigation systems; Operative Time; Paroxysmal tachycardia; Patients; Prospective Studies; Radiation (Physics); Radiation exposure; Radiation Exposure - adverse effects; Radiation Exposure - prevention & control; Radiofrequency ablation; Radiography, Interventional - adverse effects; Recurrence; Registries; Researchers; Risk Factors; Safety; Success; Supraventricular tachycardia; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - instrumentation; Tachycardia; Tachycardia, Supraventricular - diagnostic imaging; Tachycardia, Supraventricular - physiopathology; Tachycardia, Supraventricular - surgery; Time; Time Factors; Treatment Outcome; Veins & arteries; Zero-fluoroscopy
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-020-01344-0

Three-dimensional electroanatomic mapping systems have demonstrated a significant reduction in radiation exposure during radiofrequency catheter ablation procedures. We aimed to investigate the safety, feasibility and efficacy of a completely zero-fluoroscopy approach for catheter ablation of supraventricular tachycardia using the Ensite NavX navigation system compared with a conventional fluoroscopy approach. A multicenter prospective non-randomized registry study was performed in seven centers from January 2013 to February 2018. Consecutive patients referred for catheter ablation of supraventricular tachycardia were assigned either to a completely zero-fluoroscopic approach (ZF) or conventional fluoroscopy approach (CF) according to the operator's preference. Patients with atrial tachycardia were excluded. Totally, 1020 patients were enrolled in ZF group; 2040 patients ablated by CF approach were selected for controls. There was no significant difference between the zero-fluoroscopy group and conventional fluoroscopy group as to procedure time (60.3 ± 20.3 vs. 59.7 ± 22.6 min, P = 0.90), immediate success rate of procedure (98.8% vs. 99.2%, P = 0.22), arrhythmia recurrence (0.4% vs. 0.5%, P = 0.85), total success rate of procedure (98.4% vs. 98.8%, P = 0.39) or complications (1.1% vs. 1.5%, P = 0.41). Compared with the conventional fluoroscopy approach, the zero-fluoroscopy approach provided similar outcomes without compromising the safety or efficacy of the procedure. The completely zero-fluoroscopy approach demonstrated safety and efficacy comparable to a conventional fluoroscopy approach for catheter ablation of supraventricular tachycardia, and mitigated radiation exposure to both patients and operators. clinicaltrials.gov Identifier: NCT03042078; first registered February 3, 2017; retrospectively registered.