Near-zero fluoroscopy during electroanatomic mapping-guided pediatric catheter ablation

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: The use of fluoroscopy in pediatric catheter ablation has decreased because of mapping systems. However, the safety, feasibility and efficacy of the technique in pediatric populations have yet to be delineated. OBJECTIVE: In this study, we present the efficiency and reliability of the electroanatomic mapping system in near/zero fluoroscopic pediatric catheter ablation. METHODS: The medical records of patients aged <18 years who underwent ablation between April 2022 and November 2022 were evaluated. Fluoroscopy was not used in cases involving ablation of right sided-arrhythmia foci. Fluoroscopy was used only for trans-septal puncture or retroaortic approach/coronary angiography. RESULTS: A total of 28 patients underwent catheter ablation for supraventricular and ventricular tachyarrhythmia substrates under the guidance of mapping system. Fluoroscopy was used in only 4 (14.2%) of these substrates. The mean fluoroscopy duration in these 4 procedures was 4.2±3.13 min. No complications were noted. The acute success rate in achieving complete elimination of arrhythmia substrates was 100%. The recurrence rate was 3,5% (1/28) at follow-up. CONCLUSION: The fluoroscopy can be completely eliminated in most pediatric catheter ablation procedures with the use of mapping systems by achieving high acute success rates and this technique is safe, feasible and effective. [Figure: see text]