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Fluoroless cavotricuspid isthmus ablation successfully achieves atrial flutter control
Session:
Comunicações Orais (Sessão 13) - Arritmias 3 - Fibrilhação auricular
Speaker:
Sofia Jacinto
Congress:
CPC 2022
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
06.4 Supraventricular Tachycardia (non-AF) - Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Sofia Jacinto; Pedro Silva Cunha; Guilherme Portugal; Bruno Valente; Madalena Coutinho Cruz; Ana Lousinha; José Veiga; Ana Sofia Delgado; Manuel Brás; Margarida Paulo; Cátia Guerra; Ana Rita Teixeira; Bárabara Lacerda Teixeira; Rui Cruz Ferreira; Mário Martins Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-size:11pt">Cavotricuspid isthmus (CTI) ablation in patients with typical atrial flutter (AFL) has improved in the past years, especially by the use of three-dimensional (3D) electroanatomic mapping systems. These mapping tools contributed to reduce radiation exposure, but most ablation procedures still require varying amounts of fluoroscopy. <strong>Objective: </strong>We aim to examine whether fluoroless CTI ablation is effective and safe in reducing AFL recurrence, compared with CTI ablation using fluoroscopy and a 3D mapping system. <strong>Methods: </strong>A retrospective analysis of CTI ablation procedures performed at a tertiary center between December 2008 and December 2020 was conducted. Cases were divided in two groups: fluoroless and fluoroscopic, according to the use of radiation. Procedural duration, fluoroscopy time (FT), use of 3D mapping system, complications and recurrence rates at one year were analyzed. <strong>Results: </strong>A total of 324 CTI ablations performed on patients with documented typical AFL were included. Mean age was 62.3±14.0, with 78.1% male patients. Fluoroless ablations were performed based on a 3D mapping system, and all fluoroscopic procedures also used 3D electroanatomic mapping. The FT was zero in the fluoroless group - 31 cases (9.6%), and 7.0±4.4 minutes in the fluoroscopic group - 291 cases (90.4%) (p<0.001). There was no statistically significant difference between the two groups, regarding AFL recurrence at one year (21.7% in the fluoroless group vs. 13% in the fluoroscopic group; odds ratio [OD] 0.54; 95% confidence interval [CI] 0.18-1.62; p=0.27). Total procedure duration was significantly shorter in the fluoroless group (1h07m vs. 1h40m; t-test 4.261, p<0.001, CI 0h16m-0h50m). There were no acute complications for both groups. <strong>Conclusion: </strong>Fluoroless CTI ablation, avoiding any radiation exposure to the patient and operator, can be performed in patients with typical AFL, without compromising duration, safety or efficacy of the procedure. </span></span></span></span></p>
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