title: A new electrophysiology era:  zero fluoroscopy.
abstract: Catheter ablations are traditionally performed under fluoroscopic guidance. Besides other peri-interventional risks, radiation exposure should be considered for its stochastic and deterministic effects on health. These effects are cumulative and lifelong and raise great concerns especially in the younger population. A document of the American College of Cardiology recommends that all catheterization laboratories adopt the principles of 'ALARA' (radiation doses 'As Low As Reasonably Achievable'), making radiation reduction an ethical issue. In electrophysiology, thanks to the recent development of electroanatomic navigation systems, we are witnessing the birth of a new era in which almost all arrhythmias may be treated without the use of fluoroscopy. In the present review, we start by describing risks to health due to radiation exposure for conventional transcatheter ablations and we continue by reporting the current state of art of the zero fluoroscopy approach.
authors.affiliation: Cardiology Division, Department of Internal Medicine, University of Turin, Turin, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Anselmino
authors.forename: Dario
authors.initials: D
authors.lastname: Sillano
authors.forename: Dario
authors.initials: D
authors.lastname: Casolati
authors.forename: Federico
authors.initials: F
authors.lastname: Ferraris
authors.forename: Marco
authors.initials: M
authors.lastname: Scaglione
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000639:trends; D004781:Environmental Exposure / Q000517:prevention & control; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000009:adverse effects*