Non-Fluoroscopic Catheter Visualization in AF Ablation: Experience from 375 Consecutive Procedures
Background—A technological platform (MediGuide™) has been recently introduced for non-fluoroscopic catheter tracking. No data on the safety of this technology is yet available in a large cohort of patients.
Methods and Results—Data from a prospective ablation registry were analyzed. All patients undergoing AF ablation procedures supported by non-fluoroscopic catheter visualization technology (NFCV) were included. Patient characteristics and procedural data and complications within the first 3 months were recorded. Between May 2012 and February 2014, a total of 375 patients underwent AF ablation using NFCV technology. The patients were predominantly male (68%), the majority was ablated for the first time (71%), LA was 43±6mm and LV function was normal (59±9%). The median ablation procedure time was 135min [113; 170], median fluoroscopy time 2.8 min [1.5; 4.4] and median radiation dose 789cGy*cm2 [470; 1466]. Regression analysis demonstrated a significant decrease of fluoroscopy time, -dose and procedure time. To confirm the result and show overall changes, the initial 50 cases (group I) to the last 50 cases (group II) of the series were compared: fluoroscopy time decreased from 6.0min [4.1; 10.3] in group I to 1.1min [0.7; 1.5] in group II and radiation dose from 2363cGy*cm2 [1413; 3475] to 490cGy*cm2 [230; 654], respectively. 10 patients (2.7%) experienced complications: 5 cardiac tamponades (1.4%), 4 pseudoaneurysms (1.1%), and 1 stroke (0.3%).
Conclusions—AF ablation utilizing the NFCV technology is safe with a rate of complications of 2.7%. Procedure time (135min) is not prolonged. A dramatic reduction in fluoroscopy time and dose was achieved.
- Received February 19, 2014.
- Revision received June 3, 2014.
- Accepted June 6, 2014.