Title:How to Achieve Near Zero Fluoroscopy During Radiofrequency Ablation of Atrial Fibrillation: A Strategy Used at Two Centers
Volume: 17
Issue: 4
Author(s): Abdul Q. Haji, Mohammed B. Naji, Shakeel Jamal and Khalil Kanjwal*
Affiliation:
- Department of Cardiology, McLaren Greater Lansing Hospital, Lansing, MI 48910,United States
Keywords:
Atrial fibrillation, radiofrequency, ablation, intracardiac echo, 3D mapping, zero fluoroscopy.
Abstract: Radiofrequency ablation for atrial fibrillation is currently the most effective rhythm control
strategy. These procedures, although safe, pose a risk for potential exposure to radiation and
can be time consuming. Radiation exposure during ablation can increase the risk of serious complications
in both patients as well as physicians. The overall procedure time also increases with use of
fluoroscopy. Advances in mapping technology, such as electroanatomic mapping, use of contact
force technology, intracardiac echocardiography and use of versatile sheaths and catheters has vastly
enhanced our ability to both shorten the procedure duration and minimize or even eliminate radiation
exposure. Use of near zero fluoroscopy technique is increasingly gaining acceptance in electrophysiology
centers. At this point, there is no uniform technique and various centers use individual
techniques based on their expertise and availability of various tools. There is need for a uniform
technique that is workflow friendly and widely accepted. There is a learning curve associated with
this technique and efforts should be made to incorporate zero fluoroscopic technique for ablation as
an essential part of electrophysiology training programs. In this paper, we present the strategy being
practiced at two centers, that involves a series of steps, to either decrease or eliminate the use
of fluoroscopy during atrial fibrillation ablation.
