Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach
Background: A widely used method of treating left-sided arrhythmia substrates in children is retrograde transaortic ablation under fluoroscopic guidance. However, the feasibility, safety, and efficacy of this approach under zero fluoroscopy (ZF) guidance, especially the mid-term safety of anatomy an...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664622000961 |
| _version_ | 1811261520142663680 |
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| author | Wei-Chieh Tseng Mei-Hwan Wu Chun-Wei Lu Kun-Lang Wu Jou-Kou Wang Ming-Tai Lin Chun-An Chen Cheng-Wei Chen Shuenn-Nan Chiu |
| author_facet | Wei-Chieh Tseng Mei-Hwan Wu Chun-Wei Lu Kun-Lang Wu Jou-Kou Wang Ming-Tai Lin Chun-An Chen Cheng-Wei Chen Shuenn-Nan Chiu |
| author_sort | Wei-Chieh Tseng |
| collection | DOAJ |
| description | Background: A widely used method of treating left-sided arrhythmia substrates in children is retrograde transaortic ablation under fluoroscopic guidance. However, the feasibility, safety, and efficacy of this approach under zero fluoroscopy (ZF) guidance, especially the mid-term safety of anatomy and function of aortic valves, have yet to be proven. Methods: All consecutive patients who received ablation of left-sided arrhythmias between January 2012 and June 2020 and below 20 years-old were enrolled. The study group submitted to 55 ZF-guided procedures using cardiac mapping system (EnSite Precision), whereas 49 procedures were performed under fluoroscopic guidance in the control group. Echocardiographic studies took place before and 6-months after ablative procedures. Results: One-hundred-and-two patients (male, 66; female, 36) underwent a total of 104 ablative procedures. Mean procedural durations were 83.9 ± 44.4 min in the study group and 64.8 ± 29.1 min in the control group, respectively (p = .01; the 95% confidence interval, −33.57 to −4.63). Corresponding fluoroscopic times were .5 ± 2.2 min and 24.7 ± 13.9 min (p < .001; the 95% confidence interval, 20.15 to 28.22). ZF may be reasonably applied after a learning curve of 20 cases. Immediate procedural success and recurrence rates were similar in each groups. There was no detectable progression of aortic regurgitation in any of the patients during serial follow-up of echocardiography. Conclusion: ZF-guided retrograde transaortic ablation of left-sided arrhythmia substrates proved safe in children at midterm follow-up, reducing radiation exposure significantly within a learning curve of <20 cases. |
| first_indexed | 2024-04-12T19:06:09Z |
| format | Article |
| id | doaj.art-c167206c3aa1402b9eed08322fc809b8 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-12T19:06:09Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-c167206c3aa1402b9eed08322fc809b82022-12-22T03:20:01ZengElsevierJournal of the Formosan Medical Association0929-66462022-10-011211020352043Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approachWei-Chieh Tseng0Mei-Hwan Wu1Chun-Wei Lu2Kun-Lang Wu3Jou-Kou Wang4Ming-Tai Lin5Chun-An Chen6Cheng-Wei Chen7Shuenn-Nan Chiu8Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, Changhua Christian Hospital, Changhua, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanCardiovascular Center, National Taiwan University Hospital/National Taiwan University Children's Hospital, TaiwanDepartment of Pediatrics, National Taiwan University Hospital/National Taiwan University Children's Hospital, Taiwan; Corresponding author. Department of Pediatrics, National Taiwan University Hospital, No 7, Chun-Shan South Road, Taipei 100, Taiwan. Fax: +886 2 23147450.Background: A widely used method of treating left-sided arrhythmia substrates in children is retrograde transaortic ablation under fluoroscopic guidance. However, the feasibility, safety, and efficacy of this approach under zero fluoroscopy (ZF) guidance, especially the mid-term safety of anatomy and function of aortic valves, have yet to be proven. Methods: All consecutive patients who received ablation of left-sided arrhythmias between January 2012 and June 2020 and below 20 years-old were enrolled. The study group submitted to 55 ZF-guided procedures using cardiac mapping system (EnSite Precision), whereas 49 procedures were performed under fluoroscopic guidance in the control group. Echocardiographic studies took place before and 6-months after ablative procedures. Results: One-hundred-and-two patients (male, 66; female, 36) underwent a total of 104 ablative procedures. Mean procedural durations were 83.9 ± 44.4 min in the study group and 64.8 ± 29.1 min in the control group, respectively (p = .01; the 95% confidence interval, −33.57 to −4.63). Corresponding fluoroscopic times were .5 ± 2.2 min and 24.7 ± 13.9 min (p < .001; the 95% confidence interval, 20.15 to 28.22). ZF may be reasonably applied after a learning curve of 20 cases. Immediate procedural success and recurrence rates were similar in each groups. There was no detectable progression of aortic regurgitation in any of the patients during serial follow-up of echocardiography. Conclusion: ZF-guided retrograde transaortic ablation of left-sided arrhythmia substrates proved safe in children at midterm follow-up, reducing radiation exposure significantly within a learning curve of <20 cases.http://www.sciencedirect.com/science/article/pii/S0929664622000961ArrhythmiaElectrophysiologyCatheter ablationPediatrics |
| spellingShingle | Wei-Chieh Tseng Mei-Hwan Wu Chun-Wei Lu Kun-Lang Wu Jou-Kou Wang Ming-Tai Lin Chun-An Chen Cheng-Wei Chen Shuenn-Nan Chiu Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach Journal of the Formosan Medical Association Arrhythmia Electrophysiology Catheter ablation Pediatrics |
| title | Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach |
| title_full | Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach |
| title_fullStr | Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach |
| title_full_unstemmed | Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach |
| title_short | Zero-fluoroscopy ablation of left-sided arrhythmia substrates in children – Mid-term safety and feasibility study from transaortic approach |
| title_sort | zero fluoroscopy ablation of left sided arrhythmia substrates in children mid term safety and feasibility study from transaortic approach |
| topic | Arrhythmia Electrophysiology Catheter ablation Pediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S0929664622000961 |
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