Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway
Background: Catheter ablation (CA) is a safe and efficient treatment in patients with an atrioventricular accessory pathway (AP). Electroanatomical mapping (EAM) systems are useful during CA of AP, especially for reducing fluoroscopy. There are limited data about the feasibility of CA procedures per...
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/7/1814 |
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| author | Dariusz Rodkiewicz Edward Koźluk Agnieszka Piątkowska Aleksandra Gąsecka Krzysztof Krzemiński Grzegorz Opolski |
| author_facet | Dariusz Rodkiewicz Edward Koźluk Agnieszka Piątkowska Aleksandra Gąsecka Krzysztof Krzemiński Grzegorz Opolski |
| author_sort | Dariusz Rodkiewicz |
| collection | DOAJ |
| description | Background: Catheter ablation (CA) is a safe and efficient treatment in patients with an atrioventricular accessory pathway (AP). Electroanatomical mapping (EAM) systems are useful during CA of AP, especially for reducing fluoroscopy. There are limited data about the feasibility of CA procedures performed with the use of the EAM system entirely without fluoroscopy in adults with AP. The aim of the study is to assess the feasibility, efficacy and safety of CA with the use of EAM without fluoroscopy, compared to CA with EAM and fluoroscopy in patients with AP. Methods: The study included 83 consecutive patients (age 38.25 ± 15.8 years), who were subjected to CA for AP. In 40 patients CA was performed with the use of EAM without fluoroscopy (EAM group), and in 43 patients CA was performed with EAM and fluoroscopy (control group). Baseline characteristics, procedure parameters and complications were obtained from the medical records. Data on permanent success rate was obtained after the mean follow-up time of 1 year. Primary outcomes were acute procedural success rate, long term success rate at 1-year follow-up and complications. Secondary outcomes were the procedure time and number of applications. Results: There were no statistically significant differences in baseline characteristics between the groups, except for the AP locations. Right-sided AP was more common in the EAM group, while left-sided AP was more common in the control group (<i>p</i> = 0.007 and <i>p</i> = 0.004, respectively). Acute procedural success was achieved in 38 patients (95.0%) in the EAM group and in 39 patients (90.7%) in the control group (<i>p</i> = 0.449). Long term success rate was achieved in 36 patients (90.0%) in the EAM group and in 36 (83.7%) patients in the control group (<i>p</i> = 0.399). There was one minor complication in the form of RBBB in the EAM group (<i>p</i> = 0.138). The mean procedure time was shorter in the EAM group compared to the control group (93.0 ± 58.3 min vs. 127.6 ± 57.5 min; <i>p</i> = 0.009). Conclusions: CA of both right-sided and left-sided AP completely guided by EAM without the use of fluoroscopy is feasible, safe and effective. |
| first_indexed | 2024-03-09T11:43:56Z |
| format | Article |
| id | doaj.art-dbf3f972e6a346cc9a0069a086598c7b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T11:43:56Z |
| publishDate | 2022-03-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-dbf3f972e6a346cc9a0069a086598c7b2023-11-30T23:27:14ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01117181410.3390/jcm11071814Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory PathwayDariusz Rodkiewicz0Edward Koźluk1Agnieszka Piątkowska2Aleksandra Gąsecka3Krzysztof Krzemiński4Grzegorz Opolski5Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Cardiology, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Cardiology, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Cardiology, Medical University of Warsaw, 02-091 Warsaw, PolandDepartment of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, PolandDepartment of Cardiology, Medical University of Warsaw, 02-091 Warsaw, PolandBackground: Catheter ablation (CA) is a safe and efficient treatment in patients with an atrioventricular accessory pathway (AP). Electroanatomical mapping (EAM) systems are useful during CA of AP, especially for reducing fluoroscopy. There are limited data about the feasibility of CA procedures performed with the use of the EAM system entirely without fluoroscopy in adults with AP. The aim of the study is to assess the feasibility, efficacy and safety of CA with the use of EAM without fluoroscopy, compared to CA with EAM and fluoroscopy in patients with AP. Methods: The study included 83 consecutive patients (age 38.25 ± 15.8 years), who were subjected to CA for AP. In 40 patients CA was performed with the use of EAM without fluoroscopy (EAM group), and in 43 patients CA was performed with EAM and fluoroscopy (control group). Baseline characteristics, procedure parameters and complications were obtained from the medical records. Data on permanent success rate was obtained after the mean follow-up time of 1 year. Primary outcomes were acute procedural success rate, long term success rate at 1-year follow-up and complications. Secondary outcomes were the procedure time and number of applications. Results: There were no statistically significant differences in baseline characteristics between the groups, except for the AP locations. Right-sided AP was more common in the EAM group, while left-sided AP was more common in the control group (<i>p</i> = 0.007 and <i>p</i> = 0.004, respectively). Acute procedural success was achieved in 38 patients (95.0%) in the EAM group and in 39 patients (90.7%) in the control group (<i>p</i> = 0.449). Long term success rate was achieved in 36 patients (90.0%) in the EAM group and in 36 (83.7%) patients in the control group (<i>p</i> = 0.399). There was one minor complication in the form of RBBB in the EAM group (<i>p</i> = 0.138). The mean procedure time was shorter in the EAM group compared to the control group (93.0 ± 58.3 min vs. 127.6 ± 57.5 min; <i>p</i> = 0.009). Conclusions: CA of both right-sided and left-sided AP completely guided by EAM without the use of fluoroscopy is feasible, safe and effective.https://www.mdpi.com/2077-0383/11/7/1814catheter ablationfluoroscopy eliminationelectroanatomic mappingaccessory pathway |
| spellingShingle | Dariusz Rodkiewicz Edward Koźluk Agnieszka Piątkowska Aleksandra Gąsecka Krzysztof Krzemiński Grzegorz Opolski Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway Journal of Clinical Medicine catheter ablation fluoroscopy elimination electroanatomic mapping accessory pathway |
| title | Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway |
| title_full | Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway |
| title_fullStr | Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway |
| title_full_unstemmed | Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway |
| title_short | Efficacy and Safety of Zero-Fluoroscopy Approach during Catheter Ablation of Accessory Pathway |
| title_sort | efficacy and safety of zero fluoroscopy approach during catheter ablation of accessory pathway |
| topic | catheter ablation fluoroscopy elimination electroanatomic mapping accessory pathway |
| url | https://www.mdpi.com/2077-0383/11/7/1814 |
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