Conventional fluoroscopy-guided versus zero-fluoroscopy catheter ablation of supraventricular tachycardias

BMC Cardiovasc Disord. 2022 Mar 13;22(1):98. doi: 10.1186/s12872-022-02544-6.

Abstract

Purpose: The aim of this study was to evaluate the safety and efficacy of zero-fluoroscopy (ZF) catheter ablation (CA) for supraventricular tachycardias (SVT).

Methods: 584 consecutive patients referred to our institution for CA of SVT were analysed. Patients were categorised into two groups; zero-fluoroscopy (ZF) group and conventional fluoroscopy (CF) group. The ZF group was further divided into two subgroups (adults and paediatric). Patient characteristics, procedural information, and follow-up data were compared.

Results: The ZF group had a higher proportion of paediatric patients (42.2% vs 0.0%; p < 0.001), resulting in a younger age (30.9 ± 20.3 years vs 52.7 ± 16.5 years; p < 0.001) and lower BMI (22.8 ± 5.7 kg/m2 vs 27.0 ± 5.4 kg/m2; p < 0.001). Procedure time was shorter in the ZF group (94.2 ± 50.4 min vs 104.0 ± 54.0 min; p = 0.002). There were no major complications and the rate of minor complications did not differ between groups (0.0% vs 0.4%; p = 0.304). Acute procedural success as well as the long-term success rate when only the index procedure was considered did not differ between groups (92.5% vs 95.4%; p = 0.155; 87.1% vs 89.2%; p = 0.422). When repeated procedures were included, the long-term success rate was higher in the ZF group (98.3% vs 93.5%; p = 0.004). The difference can be partially explained by the operators' preferences.

Conclusion: The safety and efficacy of ZF procedures in adult and paediatric populations are comparable to that of CF procedures.

Keywords: Cryoablation; Intracardiac echocardiography; Paediatric population; Supraventricular tachycardia; Three-dimensional electroanatomic mapping system; Zero-fluoroscopy.

MeSH terms

  • Adolescent
  • Adult
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / methods
  • Child
  • Fluoroscopy
  • Humans
  • Middle Aged
  • Tachycardia, Supraventricular* / diagnostic imaging
  • Tachycardia, Supraventricular* / surgery
  • Time Factors
  • Treatment Outcome
  • Young Adult