TY - JOUR
T1 - Long-Term Outcomes of Near-Zero Radiation Ablation of Paroxysmal Supraventricular Tachycardia
T2 - A Comparison With Fluoroscopy-Guided Approach
AU - Bergonti, Marco
AU - Dello Russo, Antonio
AU - Sicuso, Rita
AU - Ribatti, Valentina
AU - Compagnucci, Paolo
AU - Catto, Valentina
AU - Gasperetti, Alessio
AU - Zucchetti, Martina
AU - Cellucci, Selene
AU - Vettor, Giulia
AU - Dessanai, Maria Antonietta
AU - Majocchi, Benedetta
AU - Moltrasio, Massimo
AU - Russo, Eleonora
AU - Stronati, Giulia
AU - Guerra, Federico
AU - Di Biase, Luigi
AU - Natale, Andrea
AU - Tondo, Claudio
AU - Casella, Michela
N1 - Publisher Copyright:
© 2021 American College of Cardiology Foundation
PY - 2021/9
Y1 - 2021/9
N2 - Objectives: This study aimed to assess the long-term outcomes of minimally fluoroscopic approach (MFA) compared with conventional fluoroscopic ablation (ConvA) in terms of recurrences of arrhythmia and long-term complications. Background: Catheter ablation (CA) of supraventricular tachycardia (SVT) with an MFA, under the guidance of electroanatomic mapping (EAM) systems, results in a significant reduction in exposure to ionizing radiations without impairing acute procedural success and complication rate. However, data regarding long-term outcomes of MFA compared with ConvA are lacking. Methods: This is a retrospective observational study. All patients undergoing MFA CA of SVT (atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia) between 2010 and 2015 were enrolled and were compared with matched subjects (1 MFA: 2 ConvA) undergoing ConvA during the same period. The 2 co-primary outcomes were recurrence of arrhythmias and long-term complications. Results: A total of 618 patients (mean age 38 ± 15 years, 60% female) were enrolled. MFA included 206 patients, whereas 412 were treated with ConvA. Acute success (99% vs. 97%; p = 0.10) and acute complications (2.4% vs. 5.3%; p = 0.14) were similar in the 2 groups. During a median follow-up of 4.4 years, 5.9% of patients experienced recurrence of arrhythmias. At multivariate analysis, ConvA (hazard ratio [HR]: 3.03) and procedural success (HR: 0.10) were independently associated with recurrence of arrhythmias. Late complications (i.e., advance atrioventricular block and need for pacemaker implantation) occurred more frequently in ConvA (3.4% vs. 0.5%; p = 0.03) compared with MFA. Conclusions: CA guided by EAM systems with MFA provided better long-term results and reduced risk of complications compared with ConvA.
AB - Objectives: This study aimed to assess the long-term outcomes of minimally fluoroscopic approach (MFA) compared with conventional fluoroscopic ablation (ConvA) in terms of recurrences of arrhythmia and long-term complications. Background: Catheter ablation (CA) of supraventricular tachycardia (SVT) with an MFA, under the guidance of electroanatomic mapping (EAM) systems, results in a significant reduction in exposure to ionizing radiations without impairing acute procedural success and complication rate. However, data regarding long-term outcomes of MFA compared with ConvA are lacking. Methods: This is a retrospective observational study. All patients undergoing MFA CA of SVT (atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia) between 2010 and 2015 were enrolled and were compared with matched subjects (1 MFA: 2 ConvA) undergoing ConvA during the same period. The 2 co-primary outcomes were recurrence of arrhythmias and long-term complications. Results: A total of 618 patients (mean age 38 ± 15 years, 60% female) were enrolled. MFA included 206 patients, whereas 412 were treated with ConvA. Acute success (99% vs. 97%; p = 0.10) and acute complications (2.4% vs. 5.3%; p = 0.14) were similar in the 2 groups. During a median follow-up of 4.4 years, 5.9% of patients experienced recurrence of arrhythmias. At multivariate analysis, ConvA (hazard ratio [HR]: 3.03) and procedural success (HR: 0.10) were independently associated with recurrence of arrhythmias. Late complications (i.e., advance atrioventricular block and need for pacemaker implantation) occurred more frequently in ConvA (3.4% vs. 0.5%; p = 0.03) compared with MFA. Conclusions: CA guided by EAM systems with MFA provided better long-term results and reduced risk of complications compared with ConvA.
KW - catheter ablation
KW - electroanatomic mapping system
KW - minimally fluoroscopic approach
KW - near-zero fluoroscopy
KW - supraventricular arrhythmia
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U2 - 10.1016/j.jacep.2021.02.017
DO - 10.1016/j.jacep.2021.02.017
M3 - Article
C2 - 33933407
AN - SCOPUS:85107123353
SN - 2405-500X
VL - 7
SP - 1108
EP - 1117
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 9
ER -