title: Manifold benefits of choosing a minimally fluoroscopic catheter ablation approach.
abstract: We report the case of a 14-year-old boy with ventricular preexcitation. A standard, fluoroscopy guided, ablation procedure was successfully performed in a postero-midseptal region with a total fluoroscopy time of about 45 min (2430 cGy.cm(2)). A few hours after the procedure, preexcitation reappeared. A second ablation procedure was scheduled using the EnSite NavX™ mapping system. During mapping along the tricuspid groove, preexcitation suddenly disappeared due to mechanical "bumping" of the accessory pathway and it did not recover over the next 30 min. As per our routine practice, the phase of geometry reconstruction has been continuously recorded by the system; thus, an off-line analysis allowed to pinpoint the site of earliest activation and the site of mechanical bumping, where radiofrequency obtained the accessory pathway ablation. The second procedure was performed without using fluoroscopy at all. Thanks to the geometry reconstruction, the procedure was completely successful thus avoiding a further rehospitalization.
authors.affiliation: Michela Casella, Antonio Dello Russo, Gaetano Fassini, Stefano Bartoletti, Stefania Riva, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Casella
authors.forename: Antonio
authors.initials: A
authors.lastname: Dello Russo
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fassini
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.forename: Pasquale
authors.initials: P
authors.lastname: De Iuliis
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.forename: Stefano
authors.initials: S
authors.lastname: Bartoletti
authors.forename: Stefania
authors.initials: S
authors.lastname: Riva
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
keywords: Accessory pathway; Electroanatomical mapping; Radiation exposure; Radiofrequency ablation; Supraventricular arrhythmias
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