Nonfluoroscopic catheter ablation of paroxysmal atrial fibrillation.
Pacing Clin Electrophysiol
; 41(6): 611-619, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-29566268
ABSTRACT
AIMS:
Radiofrequency catheter ablation of atrial fibrillation (AF) is one of the most complex ablation procedures. Both patients and operators are exposed to scattered radiation. This study evaluated the safety and efficacy of intracardiac echo (ICE)-guided pulmonary vein isolation (PVI) without fluoroscopy.METHODS:
We retrospectively analyzed the data of 481 consecutive patients with paroxysmal AF undergoing radiofrequency PVI with the CARTO 3 system (Biosense Webster, Diamond Bar, CA, USA). ICE-guided PVI without fluoroscopy and without CT/MRI integration (Nonfluoro group) was performed for 245 patients, and conventional fluoroscopy-guided PVI (Fluoro group) was performed for 236 patients. The primary safety endpoint was the incidence of major adverse events. The primary efficacy endpoint was freedom from AF during follow-up. Secondary endpoints included procedure duration, fluoroscopy duration, and acute PVI rate.RESULTS:
Mean procedure times between groups were similar (108.8 ± 18.2 minutes in the Non-fluoro group vs 113.6 ± 26.8 minutes in the Fluoro group; P = not significant [NS]). Acute PVI was achieved in all patients, with mean radiofrequency application times of 43.4 ± 7.5 and 44.4 ± 10.7 minutes for the Nonfluoro and Fluoro groups, respectively (P = NS). The incidence of cardiac tamponade was 1.2% (3/245 patients) in the Nonfluoro group and 0.8% (2/236 patients) in the Fluoro group (P = NS). During 15.2 ± 4.1 months of follow-up, after a single procedure, AF recurrence was documented in 65 of 245 (26.5%) patients and 61 of 236 (25.8%) patients in the Nonfluoro and Fluoro groups, respectively (P = NS).CONCLUSIONS:
Nonfluoroscopic ICE-guided catheter ablation of AF without prior cardiac image integration or angiography is feasible and safe. PVI without fluoroscopy did not affect procedure duration or long-term efficacy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Ablação por Cateter
/
Gestão da Segurança
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Federação Russa