Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system
Abstract Background Radiofrequency catheter ablation is the preferred treatment choice for ventricular arrhythmias (VAs) originating from right ventricular outflow tract (RVOT) in symptomatic patients and is usually performed under fluoroscopy guidance. Zero‐fluoroscopy (ZF) ablations using 3D mappi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-04-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12815 |
| _version_ | 1797833567025233920 |
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| author | Ba Van Vu Phong Dinh Phan Linh Tran Pham Kien Trung Hoang Thinh Duc Do Hung Manh Nguyen Linh Thi Hai Ngo Dung Tien Le Nguyen Thao Phan Huu Cong Nguyen Thuc Cong Luong |
| author_facet | Ba Van Vu Phong Dinh Phan Linh Tran Pham Kien Trung Hoang Thinh Duc Do Hung Manh Nguyen Linh Thi Hai Ngo Dung Tien Le Nguyen Thao Phan Huu Cong Nguyen Thuc Cong Luong |
| author_sort | Ba Van Vu |
| collection | DOAJ |
| description | Abstract Background Radiofrequency catheter ablation is the preferred treatment choice for ventricular arrhythmias (VAs) originating from right ventricular outflow tract (RVOT) in symptomatic patients and is usually performed under fluoroscopy guidance. Zero‐fluoroscopy (ZF) ablations using 3D mapping system applied for treatment of various types of arrhythmias are trending and practiced in many centers around the world, but rarely done in Vietnam. The objective of this study was to evaluate the efficacy and safety of zero‐fluoroscopy ablation of RVOT VAs, compared with fluoroscopy‐guided ablation without a 3D electroanatomic mapping (EAM) system. Methods and Results We conducted a nonrandomized, prospective single‐center study including 114 patients with RVOT VAs that had electrocardiographic features of typical left bundle branch block, inferior axis QRS morphology, and a precordial transition ≥ V3, from May 2020 to July 2022. The patients were assigned (without randomization) to two different approaches of either zero‐fluoroscopy ablation under the guidance of the Ensite system (ZF group) or fluoroscopy‐guided ablation without a 3D EAM (fluoroscopy group) in a 1:1 ratio. After a follow‐up time of 5.0 ± 4.9 months and 6.9 ± 9.3 months in the ZF and fluoroscopy groups, respectively, the results showed a higher success rate in the fluoroscopy group than in the complete ZF group (87.3% vs 86.8%), although the difference was not statistically significant. No major complication was noted in both the groups. Conclusion ZF ablation for RVOT VAs can be done safely and effectively using the 3D electroanatomic mapping system. The results of ZF approach are comparable to that of the fluoroscopy‐guided approach without a 3D EAM system. |
| first_indexed | 2024-04-09T14:24:52Z |
| format | Article |
| id | doaj.art-3eec2234834e43849126905063c4f244 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-04-09T14:24:52Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-3eec2234834e43849126905063c4f2442023-05-04T05:38:07ZengWileyJournal of Arrhythmia1880-42761883-21482023-04-0139218519110.1002/joa3.12815Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping systemBa Van Vu0Phong Dinh Phan1Linh Tran Pham2Kien Trung Hoang3Thinh Duc Do4Hung Manh Nguyen5Linh Thi Hai Ngo6Dung Tien Le7Nguyen Thao Phan8Huu Cong Nguyen9Thuc Cong Luong10Cardiology Department Vietnam Military Medical University Hanoi VietnamCardiology Department Hanoi Medical University Hanoi VietnamVietnam National Heart Institute Bach Mai Hospital Hanoi VietnamCardiovascular Center E Hospital Hanoi VietnamCardiovascular Center E Hospital Hanoi VietnamCardiovascular Center E Hospital Hanoi VietnamSchool of Clinical Medicine The University of Queensland Herston Queensland AustraliaCardiovascular Center E Hospital Hanoi VietnamCardiovascular Center E Hospital Hanoi VietnamCardiovascular Center E Hospital Hanoi VietnamCardiology Department Vietnam Military Medical University Hanoi VietnamAbstract Background Radiofrequency catheter ablation is the preferred treatment choice for ventricular arrhythmias (VAs) originating from right ventricular outflow tract (RVOT) in symptomatic patients and is usually performed under fluoroscopy guidance. Zero‐fluoroscopy (ZF) ablations using 3D mapping system applied for treatment of various types of arrhythmias are trending and practiced in many centers around the world, but rarely done in Vietnam. The objective of this study was to evaluate the efficacy and safety of zero‐fluoroscopy ablation of RVOT VAs, compared with fluoroscopy‐guided ablation without a 3D electroanatomic mapping (EAM) system. Methods and Results We conducted a nonrandomized, prospective single‐center study including 114 patients with RVOT VAs that had electrocardiographic features of typical left bundle branch block, inferior axis QRS morphology, and a precordial transition ≥ V3, from May 2020 to July 2022. The patients were assigned (without randomization) to two different approaches of either zero‐fluoroscopy ablation under the guidance of the Ensite system (ZF group) or fluoroscopy‐guided ablation without a 3D EAM (fluoroscopy group) in a 1:1 ratio. After a follow‐up time of 5.0 ± 4.9 months and 6.9 ± 9.3 months in the ZF and fluoroscopy groups, respectively, the results showed a higher success rate in the fluoroscopy group than in the complete ZF group (87.3% vs 86.8%), although the difference was not statistically significant. No major complication was noted in both the groups. Conclusion ZF ablation for RVOT VAs can be done safely and effectively using the 3D electroanatomic mapping system. The results of ZF approach are comparable to that of the fluoroscopy‐guided approach without a 3D EAM system.https://doi.org/10.1002/joa3.12815right ventricular outflow tractventricular arrhythmiaszero‐fluoroscopy ablation |
| spellingShingle | Ba Van Vu Phong Dinh Phan Linh Tran Pham Kien Trung Hoang Thinh Duc Do Hung Manh Nguyen Linh Thi Hai Ngo Dung Tien Le Nguyen Thao Phan Huu Cong Nguyen Thuc Cong Luong Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system Journal of Arrhythmia right ventricular outflow tract ventricular arrhythmias zero‐fluoroscopy ablation |
| title | Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system |
| title_full | Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system |
| title_fullStr | Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system |
| title_full_unstemmed | Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system |
| title_short | Efficacy and safety of zero‐fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract: Comparison with fluoroscopy‐guided ablation without a three‐dimensional electroanatomic mapping system |
| title_sort | efficacy and safety of zero fluoroscopy ablation of ventricular arrhythmias originating from the right ventricular outflow tract comparison with fluoroscopy guided ablation without a three dimensional electroanatomic mapping system |
| topic | right ventricular outflow tract ventricular arrhythmias zero‐fluoroscopy ablation |
| url | https://doi.org/10.1002/joa3.12815 |
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