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Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation

BACKGROUND: Attempting to minimize radiation exposure during catheter ablation of atrial fibrillation (AF) for patients, operators and medical staffs should be performed. This study aimed to investigate the feasibility and safety of a metal interference alert guided septal approach using 3 intracard...

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Autores principales: Iwasaki, Yu-ki, Fujimoto, Yuhi, Ito-Hagiwara, Kanako, Oka, Eiichiro, Hayashi, Hiroshi, Yamamoto, Teppei, Murata, Hiroshige, Yodogawa, Kenji, Shimizu, Wataru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555271/
https://www.ncbi.nlm.nih.gov/pubmed/34746363
http://dx.doi.org/10.1016/j.ijcha.2021.100896
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author Iwasaki, Yu-ki
Fujimoto, Yuhi
Ito-Hagiwara, Kanako
Oka, Eiichiro
Hayashi, Hiroshi
Yamamoto, Teppei
Murata, Hiroshige
Yodogawa, Kenji
Shimizu, Wataru
author_facet Iwasaki, Yu-ki
Fujimoto, Yuhi
Ito-Hagiwara, Kanako
Oka, Eiichiro
Hayashi, Hiroshi
Yamamoto, Teppei
Murata, Hiroshige
Yodogawa, Kenji
Shimizu, Wataru
author_sort Iwasaki, Yu-ki
collection PubMed
description BACKGROUND: Attempting to minimize radiation exposure during catheter ablation of atrial fibrillation (AF) for patients, operators and medical staffs should be performed. This study aimed to investigate the feasibility and safety of a metal interference alert guided septal approach using 3 intracardiac echocardiography viewing positions for near-zero fluoroscopy AF ablation procedures. METHODS/RESULTS: A total of 668 procedures among 608 consecutive patients with AF (67.2 ± 7.3 years, 408 males) who underwent catheter ablation were retrospectively evaluated and divided into 2 groups, near-zero group (n = 42) and conventional group (n = 595). In the near-zero group, a metal interference alert guided septal approach with 3 different catheter intracardiac echocardiography positions to minimize the fluoroscopy time was applied, and a left atrial access with 2 long sheaths from a single septal puncture without fluoroscopy was successfully achieved in 41 out of 42 cases. The total fluoroscopy time was significantly shorter in the near-zero group than that in the conventional group (0.5 ± 2.0 vs. 21.4 ± 12.9 min p < 0.0001). The total procedure time and time to the septal puncture were both significantly longer in the near-zero group than those in the conventional group (131.4 ± 40.2 vs. 116.6 ± 46.4p = 0.0453, 31.6 ± 9.2 vs. 19.9 ± 10.2 min, p < 0.0001), The ablation time did not differ between the 2 groups (Near-zero: 99.8 ± 41.0 vs. Conventional: 96.8 ± 44.3 min, p = 0.6663). There were no significant differences in the complication rate between the 2 groups (Near-zero: 0 vs. Conventional 14 case, p = 0.6151). CONCLUSION: A metal interference alert guided septal approach using 3 intracardiac echocardiography viewing positions was feasible and safe for a near-zero fluoroscopy catheter ablation of AF.
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spelling pubmed-85552712021-11-05 Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation Iwasaki, Yu-ki Fujimoto, Yuhi Ito-Hagiwara, Kanako Oka, Eiichiro Hayashi, Hiroshi Yamamoto, Teppei Murata, Hiroshige Yodogawa, Kenji Shimizu, Wataru Int J Cardiol Heart Vasc Original Paper BACKGROUND: Attempting to minimize radiation exposure during catheter ablation of atrial fibrillation (AF) for patients, operators and medical staffs should be performed. This study aimed to investigate the feasibility and safety of a metal interference alert guided septal approach using 3 intracardiac echocardiography viewing positions for near-zero fluoroscopy AF ablation procedures. METHODS/RESULTS: A total of 668 procedures among 608 consecutive patients with AF (67.2 ± 7.3 years, 408 males) who underwent catheter ablation were retrospectively evaluated and divided into 2 groups, near-zero group (n = 42) and conventional group (n = 595). In the near-zero group, a metal interference alert guided septal approach with 3 different catheter intracardiac echocardiography positions to minimize the fluoroscopy time was applied, and a left atrial access with 2 long sheaths from a single septal puncture without fluoroscopy was successfully achieved in 41 out of 42 cases. The total fluoroscopy time was significantly shorter in the near-zero group than that in the conventional group (0.5 ± 2.0 vs. 21.4 ± 12.9 min p < 0.0001). The total procedure time and time to the septal puncture were both significantly longer in the near-zero group than those in the conventional group (131.4 ± 40.2 vs. 116.6 ± 46.4p = 0.0453, 31.6 ± 9.2 vs. 19.9 ± 10.2 min, p < 0.0001), The ablation time did not differ between the 2 groups (Near-zero: 99.8 ± 41.0 vs. Conventional: 96.8 ± 44.3 min, p = 0.6663). There were no significant differences in the complication rate between the 2 groups (Near-zero: 0 vs. Conventional 14 case, p = 0.6151). CONCLUSION: A metal interference alert guided septal approach using 3 intracardiac echocardiography viewing positions was feasible and safe for a near-zero fluoroscopy catheter ablation of AF. Elsevier 2021-10-25 /pmc/articles/PMC8555271/ /pubmed/34746363 http://dx.doi.org/10.1016/j.ijcha.2021.100896 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Iwasaki, Yu-ki
Fujimoto, Yuhi
Ito-Hagiwara, Kanako
Oka, Eiichiro
Hayashi, Hiroshi
Yamamoto, Teppei
Murata, Hiroshige
Yodogawa, Kenji
Shimizu, Wataru
Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title_full Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title_fullStr Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title_full_unstemmed Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title_short Metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
title_sort metal interference alert guided septal approach with 3 catheter positions on intracardiac echocardiography for a near-zero fluoroscopy catheter ablation of atrial fibrillation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555271/
https://www.ncbi.nlm.nih.gov/pubmed/34746363
http://dx.doi.org/10.1016/j.ijcha.2021.100896
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