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ISSN: 1734-1922
Archives of Medical Science
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4/2018
vol. 14
 
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abstract:
Clinical research

Fluoroscopy integrating technology in a 3D mapping system during ablation of atrial arrhythmias: first experiences

Christian Blockhaus, Jan Schmidt, Muhammed Kurt, Lukas Clasen, Patrick Müller, Christoph Brinkmeyer, Malte Kelm, Dong-In Shin, Hisaki Makimoto

Arch Med Sci 2018; 14, 4: 794–800
Online publish date: 2016/08/23
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Introduction
Ablation of the cavotricuspid isthmus (CTI) in patients with atrial flutter (AFL) and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are both common therapies. As the demand for ablative treatments rises, total radiation exposure times of staff increase concomitantly. Here, we report on our first experiences with a new fluoroscopy integrating system (FIS) integrated into a current 3D mapping system (3DMS).

Material and methods
The study population consisted of 59 consecutive patients who underwent PVI or CTI ablation (26 and 33 patients with and without FIS respectively). Total procedure time (PT), fluoroscopy exposure time (FT) and dose-area product (DAP) were monitored.

Results
All procedures were successfully completed without major complications. Employing FIS in the PVI group, FT and DAP were both significantly reduced after completing a short learning curve of 6 cases (respectively 361.6 ±181 s vs. 530.3 ±156.7 s, p = 0.039; 801.9 ±439.15 cGycm² vs. 1495 ±435.2 cGycm², p = 0.002). Mean PT was not significantly affected (121 ±26.7 min vs. 135.6 ±23.2 min, p = 0.21). The same holds true for CTI ablation: FT (99.29 ±51.4 s vs. 153.9 ±76.6 s, p = 0.022) and DAP (269 ±128.7 cGycm² vs. 524.3 ±288.4 cGycm², p = 0.002) were significantly reduced, leaving PT not significantly affected (29.5 ±10 min vs. 35.2 ±16.3 min, p = 0.23).

Conclusions
The introduction of the new FIS with a current 3DMS results in a significant reduction of both the total FT and DAP without affecting PT. The initial learning curve for adopting this method is considerably short.

keywords:

atrial fibrillation, atrial flutter, radiation, ablation, electroanatomical mapping

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