Impact of a Novel Catheter Tracking System on Radiation Exposure during the Procedural Phases of Atrial Fibrillation and Flutter Ablation.

Abstract

BACKGROUND:

Fluoroscopic guidance is used to position catheters during cardiac ablation. We evaluated the impact of a novel nonfluoroscopic sensor-guided electromagnetic navigation system (MG) on radiation exposure during catheter ablation of atrial fibrillation (AF) or atrial flutter (AFL).

METHODS:

A total of 134 consecutive patients referred for ablation of AF (n = 44) or AFL (n = 90) ablation were prospectively enrolled. In one group the MG system was used for nonfluoroscopic catheter positioning, whereas in the conventional group standard fluoroscopy was utilized. Fluoroscopy times were assessed for each stage of procedure and total radiation exposure was quantified.

RESULTS:

Patient characteristics were similar between the groups. The procedural end point was achieved in all. Median (interquartile range [IQR]) fluoroscopy times were 12.5 minutes (7.6, 17.4) MG group versus 21.5 minutes (15.3, 23.0) conventional group (P < 0.0001) for AF ablation, and 0.8 minutes (0.4, 2.5) MG group versus 9.9 minutes (5.1, 22.5) conventional group (P < 0.0001) for AFL ablation. Median (IQR) total radiation exposure (μGy·m(2)) was 1,107 (906, 2,033) MG group versus 2,835 (1,688, 3,855) conventional group (P = 0.0001) for AF ablation, and 161 (65, 537) MG group versus 1,651 (796, 4,569) conventional group (P < 0.0001) for AFL ablation. No difference in total procedural time was seen.

CONCLUSIONS:

The use of a novel nonfluoroscopic catheter tracking system is associated with a significant reduction in radiation exposure during AF and AFL ablation (61% and 90% reduction, respectively). In the era of heightened awareness of the importance of radiation reduction, this system represents a safe and efficient tool to decrease radiation exposure during electrophysiological ablation procedures.

• Authors: Nicolas Malliet, Jason G Andrade, Paul Khairy, Hien Kiem Nguyen Thanh, Sandrine Venier, Marc Dubuc, Katia Dyrda, Peter Guerra, Blandine Mondésert, Léna Rivard, Rafik Tadros, Mario Talajic, Bernard Thibault, Denis Roy, Laurent Macle
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 38 Issue 7 Pg. 784-90 (Jul 2015) ISSN: 1540-8159 [Electronic] United States
• PMID: 25682843 (Publication Type: Clinical Trial, Journal Article)
• Copyright: ©2015 Wiley Periodicals, Inc.

Topics

• Atrial Fibrillation (diagnostic imaging, surgery)
• Atrial Flutter (diagnostic imaging, surgery)
• Cardiac Catheters
• Catheter Ablation (methods)
• Equipment Design
• Equipment Failure Analysis
• Humans
• Radiation Dosage
• Radiation Exposure (analysis)
• Radiation Protection
• Radiography, Interventional (instrumentation, methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Treatment Outcome