NEAR ZERO FLUOROSCOPIC EXPOSURE DURING CATHETER ABLATION OF SUPRAVENTRICULAR ARRHYTHMIAS: MULTICENTER RANDOMIZED NO-PARTY TRIAL PRELIMINARY RESULTS
aM. Casella, aA. Dello Russo, §G. Pelargonio, "M. Del Greco, &G. Zingarini, *M. Piacenti, # A. Di Cori, "M. Marini, aM. Zucchetti, aE. Russo, §M. Narducci, °P. Santangeli, °L. Di Biase, *E. Picano, # M. Bongiorni, °A. Natale, aC. Tondo
a Centro Cardiologico Monzino, IRCCS, Milan, Italy § Catholic University of the Sacred Heart, Rome, Italy # Department of Cardiovascular Disease 2, S. Chiara Hospital, Hospital University of Pisa, Italy " Department of Cardiology, S. Chiara Hospital, Trento, Italy &Ospedale Santa Maria della Misericordia, ASL Perugia, Italy * CNR, Institute of Clinical Physiology, Fondazione G. Monasterio, Pisa, Italy ° Texas Cardiac Arrhythmia Institute at St Davis Medical Center, Austin, TX, USA
Introduction: Radiofrequency catheter ablation (RFCA) is the mainstay of therapy for supraventricular tachyarrhythmias (SVT). Conventional ablations require the use of fluoroscopy.
Methods: : 262 consecutive patients (mean age 35±11 years) with supraventricular tachycardia were randomized in 6 centers to undergo RFCA of SVT to either a conventional ablation technique (Group A) or one guided by non-fluoroscopic EnSite-NavXTM mapping system (Group B).
Results: RFCA was successful in all patients without complications. No significant differences were found between two Groups in mean procedure time (95±42 vs 90±36 minutes) and mean radiofrequency delivery time (430±361 vs 443±387 seconds). In 98/134 (73%) Group B patients electroanatomical mapping avoided fluoroscopy entirely. We observed a reduction in fluoroscopy time (1±2 vs 17±13 minutes, p< 0.001) and radiation dose (260±1158 vs 6447±11126 mGy/m2; p< 0.01) in Group B in comparison to Group A.
Conclusions: This is the first multicenter randomized trial showing that RFCA of SVT guided by the non-fluoroscopic EnSite NavXTM mapping system is an effective and safe approach to achieve a clinically significant reduction in ionizing radiation exposure for patient and as a consequence for operator.
