Manifold benefits of choosing a minimally fluoroscopic catheter ablation approach

We report the case of a 14-year-old boy with ventricular preexcitation. A standard, fluoroscopy guided, ablation procedure was successfully performed in a postero-midseptal region with a total fluoroscopy time of about 45 min (2430 cGy.cm2). A few hours after the procedure, preexcitation reappeared....

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Bibliographic Details
Published in:World journal of cardiology 2013-02, Vol.5 (2), p.8-11
Main Authors: Casella, Michela, Dello Russo, Antonio, Fassini, Gaetano, Andreini, Daniele, De Iuliis, Pasquale, Mushtaq, Saima, Bartoletti, Stefano, Riva, Stefania, Tondo, Claudio
Format: Article
Language:English
Subjects:
ablation
Accessory
arrhythmias
Case Report
Electroanatomical
exposure
mapping
pathway
Radiation
Radiofrequency
Supraventricular
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Summary:We report the case of a 14-year-old boy with ventricular preexcitation. A standard, fluoroscopy guided, ablation procedure was successfully performed in a postero-midseptal region with a total fluoroscopy time of about 45 min (2430 cGy.cm2). A few hours after the procedure, preexcitation reappeared. A second ablation procedure was scheduled using the EnSite NavXTM mapping system. During mapping along the tricuspid groove, preexcitation suddenly disappeared due to mechanical "bumping" of the accessory pathway and it did not recover over the next 30 min. As per our routine practice, the phase of geometry reconstruction has been continuously recorded by the system; thus, an off-line analysis allowed to pinpoint the site of earliest activation and the site of mechanical bumping, where radiofrequency obtained the accessory pathway ablation. The second procedure was performed without using fluoroscopy at all. Thanks to the geometry reconstruction, the procedure was completely successful thus avoiding a further rehospitalization.
ISSN:1949-8462
1949-8462
DOI:10.4330/wjc.v5.i2.8