title: Reduced fluoroscopy exposure during ablation of atrial fibrillation using a novel electroanatomical navigation system: a multicentre experience.
abstract: OBJECTIVE
  Catheter ablation of atrial fibrillation (AF) focuses on pulmonary vein (PV) ablation with or without additional atrial substrate modification. These procedures require significant fluoroscopy exposure. A new 3D non-fluoroscopic navigation system (CARTO(®) 3 System, Biosense Webster, CA, USA) that allows precise location visualization of diagnostic and ablation catheters was evaluated for its impact on fluoroscopic exposure during AF ablation procedures.
  
  
  RESULTS
  Two groups of patients were treated by our centres for drug refractory AF. One group was treated using the new CARTO(®) 3 system to guide catheter ablation (Group A, 117 patients). The other group was treated using the CARTO(®) XP system (Biosense Webster) 3 months previously (Group B, 123 patients). For both groups, circumferential PV ostia ablation was performed; PV isolation was validated using a circular catheter placed at each ostium. There was no difference in any clinical characteristics (age, sex, AF type, left atrium diameter and volume, and heart disease) among the two study groups. The mean number of PVs identified and isolated per patient was similar in both groups, as were the mean procedural duration and radiofrequency time. However, mean fluoroscopic time was significantly reduced in Group A (15.9±12.3 min) as compared with Group B (26±15.1 min) (P < 0.001).
  
  
  CONCLUSIONS
  This multicentre observational study demonstrates a significant reduction of fluoroscopy exposure using a new 3D non-fluoroscopic mapping system to guide AF catheter ablation.
authors: Clinica Mediterranea, Napoli, Italy. gmrstabile@tin.it
authors: Giuseppe
authors: G
authors: Stabile
authors: Marco
authors: M
authors: Scaglione
authors: Maurizio
authors: M
authors: del Greco
authors: Roberto
authors: R
authors: De Ponti
authors: Maria Grazia
authors: MG
authors: Bongiorni
authors: Franco
authors: F
authors: Zoppo
authors: Ezio
authors: E
authors: Soldati
authors: Raffaella
authors: R
authors: Marazzi
authors: Massimiliano
authors: M
authors: Marini
authors: Fiorenzo
authors: F
authors: Gaita
authors: Assunta
authors: A
authors: Iuliano
authors: Emanuele
authors: E
authors: Bertaglia
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome