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Does 3-D mapping system reduce radiation exposure comparative to conventional approach in cavotricuspid isthmus ablation procedure?
Session:
Posters 5 - Écran 4 - Arritmologia
Speaker:
Ana Marques
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
06. Supraventricular Tachycardia (non-AF)
Subtheme:
06.4 Supraventricular Tachycardia (non-AF) - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Ana I. Marques; Alexandra Briosa; Sofia Alegria; Ana Rita F. Pereira; João Simões; Carlos Alvarenga; Isabel João; Rita Miranda; Sofia Almeida; Luis Brandão; Helder Pereira
Abstract
<p><strong>Introduction: </strong>Cavotricuspid isthmus ablation in patients (pts) with atrial flutter is a common therapy. The conventional cavotricuspid isthmus ablation approach using fluoroscopy for catheter visualization and navigation is associated with radiation exposure to both patients and healthcare personnel. Nowadays, using a 3D-mapping system has been associated with a reduction in fluoroscopy time and radiation exposure at similar rates of acute procedural success, however, makes the procedure more expensive.</p> <p><strong>Aims:</strong> To compare conventional 2D fluoroscopy and 3D-mapping system approaches during cavotricuspid isthmus ablation in pts with atrial flutter regarding fluoroscopy and procedure times as well as success, recurrence and complications rates.</p> <p><strong>Methods:</strong> A single-centre retrospective study was performed, including all cavotricuspid isthmus ablation procedures performed during 2007-09/2018 period. Were excluded 8 pts with non-cavotricuspid isthmus-dependent atrial flutter and 8 pts that were submitted to ablation of the pulmonary veins in addition to cavotricuspid isthmus ablation in the same procedure.</p> <p><strong>Results:</strong> Were included 134 procedures, performed in 120 pts (97 males, mean age 64±11 years, mean ChadsVasc 2±1.4). The procedure was performed mainly due to heart failure symptoms (49%; 66 cases). At the beginning of the procedure, 58 pts were in spontaneous atrial flutter rhythm.</p> <p>In 65 cases (48.5%), the ablation procedure was performed using a conventional 2D fluoroscopy and the remain procedures were performed using a 3D-mapping system (91% NavX system, 9% CARTO system).</p> <p>The median fluoroscopy time was 8.7±8 minutes without significantly differences between conventional 2D fluoroscopy (10±8.2min) and 3D-mapping system approaches (8.8±8.5min) (p=0.16). The median procedure time was 90±30 minutes, without significantly differences between conventional 2D fluoroscopy (90±30min) and 3D-mapping system (120±30 min) techniques (p=0.61).</p> <p>Complications during hospital stay occurred in 4 pts (ischemic stroke: 1 pt; permanent pacemaker implantation: 3 pts), without differences between groups (p=0.17). The success rate was 98.5% and did not significantly differ between approaches (p=0.23).</p> <p>Was analysed the follow-up of 113 procedures. During a mean follow-up of 41±38 months, recurrence rate of atrial flutter was 20,4%, similar in both groups (p=0.56).</p> <p><strong>Conclusions:</strong> In this study, the introduction of a 3D-mapping system did not result in a significant reduction of both total fluoroscopy and procedure times comparing to conventional 2D fluoroscopy, and was observed similar success, recurrence and complications rates between techniques.</p>
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