Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis
Abstract Background Fluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. T...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-02-01
|
| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12949 |
| _version_ | 1797321511307051008 |
|---|---|
| author | Kevin Luke Clonia Milla Joshua Kurnia Tandi Rerdin Julario |
| author_facet | Kevin Luke Clonia Milla Joshua Kurnia Tandi Rerdin Julario |
| author_sort | Kevin Luke |
| collection | DOAJ |
| description | Abstract Background Fluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults. Method A systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non‐English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach. Results Seven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33–4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: −0.35 to 0.55 and SMD: −0.71, 95% CI: −1.87–0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: −1.80, 95% CI: −2.49 to −1.12 and SMD: −1.26, 95% CI: −2.24 to −0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41–2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20–0.59). Conclusion ZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure. |
| first_indexed | 2024-03-08T04:59:35Z |
| format | Article |
| id | doaj.art-99f410d9322a4b6f953fa7aaede16ff4 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-03-08T04:59:35Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-99f410d9322a4b6f953fa7aaede16ff42024-02-07T13:08:43ZengWileyJournal of Arrhythmia1880-42761883-21482024-02-01401384610.1002/joa3.12949Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysisKevin Luke0Clonia Milla1Joshua Kurnia Tandi2Rerdin Julario3Faculty of Medicine Universitas Airlangga Surabaya IndonesiaFaculty of Medicine Universitas Airlangga Surabaya IndonesiaFaculty of Medicine Universitas Tarumanagara Jakarta IndonesiaDepartment of Cardiology and Vascular Medicine Dr. Soetomo General Hospital‐Universitas Airlangga Surabaya IndonesiaAbstract Background Fluoroscopy is conventionally performed for cardiac implantable electronic device (CIED) therapy and carries radiation drawback for both patients and medical workers. Recently, zero to minimal fluoroscopy (ZMF) approach is introduced to reduce radiation exposure of fluoroscopy. This study compares the feasibility and safety of ZMF approach to fluoroscopy for CIEDs therapy in adults. Method A systematic literature search was conducted on PubMed, ScienceDirect, and Web of Science in March 2023. All observational or experimental studies comparing ZMF approach to fluoroscopy for adult CIEDs therapy were included. Reviews, case report/series, animal studies, and non‐English articles were excluded. The success rate, procedural time, fluoroscopy time, radiation dose, and complications rate were compared for each approach. Results Seven articles for permanent and three articles for temporary CIEDs were included for analysis. The success rate of ZMF for permanent CIEDs was similar to fluoroscopy method (OR: 0.77, 95% CI: 0.33–4.15). The procedural time of ZMF was similar to fluoroscopy for both permanent and temporary CIEDs (standardized mean difference [SMD]: 0.10, 95% CI: −0.35 to 0.55 and SMD: −0.71, 95% CI: −1.87–0.44, respectively). However, ZMF approach markedly reduced the fluoroscopy time and radiation exposure for permanent CIEDs (SMD: −1.80, 95% CI: −2.49 to −1.12 and SMD: −1.26, 95% CI: −2.24 to −0.29). The complication rate was similar for permanent CIEDs (OR: 1.08, 95% CI: 0.41–2.84), yet lowered for temporary CIEDs (OR: 0.34, 95% CI: 0.20–0.59). Conclusion ZMF had similar success rate, procedural time, and sum complication rate for permanent CIEDs implantation with a significant reduction of fluoroscopy time and radiation exposure.https://doi.org/10.1002/joa3.12949bradyarrhythmiacardiac resynchronization therapyfluoroscopyheart failureHis bundle pacing |
| spellingShingle | Kevin Luke Clonia Milla Joshua Kurnia Tandi Rerdin Julario Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis Journal of Arrhythmia bradyarrhythmia cardiac resynchronization therapy fluoroscopy heart failure His bundle pacing |
| title | Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis |
| title_full | Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis |
| title_fullStr | Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis |
| title_full_unstemmed | Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis |
| title_short | Zero to minimal fluoroscopy for cardiac electronic device implantation: A systematic review and meta‐analysis |
| title_sort | zero to minimal fluoroscopy for cardiac electronic device implantation a systematic review and meta analysis |
| topic | bradyarrhythmia cardiac resynchronization therapy fluoroscopy heart failure His bundle pacing |
| url | https://doi.org/10.1002/joa3.12949 |
| work_keys_str_mv | AT kevinluke zerotominimalfluoroscopyforcardiacelectronicdeviceimplantationasystematicreviewandmetaanalysis AT cloniamilla zerotominimalfluoroscopyforcardiacelectronicdeviceimplantationasystematicreviewandmetaanalysis AT joshuakurniatandi zerotominimalfluoroscopyforcardiacelectronicdeviceimplantationasystematicreviewandmetaanalysis AT rerdinjulario zerotominimalfluoroscopyforcardiacelectronicdeviceimplantationasystematicreviewandmetaanalysis |