title: Impact of a Novel Catheter Tracking System on Radiation Exposure during the Procedural Phases of Atrial Fibrillation and Flutter Ablation.
abstract: BACKGROUND
  Fluoroscopic guidance is used to position catheters during cardiac ablation. We evaluated the impact of a novel nonfluoroscopic sensor-guided electromagnetic navigation system (MG) on radiation exposure during catheter ablation of atrial fibrillation (AF) or atrial flutter (AFL).
  
  
  METHODS
  A total of 134 consecutive patients referred for ablation of AF (n = 44) or AFL (n = 90) ablation were prospectively enrolled. In one group the MG system was used for nonfluoroscopic catheter positioning, whereas in the conventional group standard fluoroscopy was utilized. Fluoroscopy times were assessed for each stage of procedure and total radiation exposure was quantified.
  
  
  RESULTS
  Patient characteristics were similar between the groups. The procedural end point was achieved in all. Median (interquartile range [IQR]) fluoroscopy times were 12.5 minutes (7.6, 17.4) MG group versus 21.5 minutes (15.3, 23.0) conventional group (P < 0.0001) for AF ablation, and 0.8 minutes (0.4, 2.5) MG group versus 9.9 minutes (5.1, 22.5) conventional group (P < 0.0001) for AFL ablation. Median (IQR) total radiation exposure (μGy·m(2)) was 1,107 (906, 2,033) MG group versus 2,835 (1,688, 3,855) conventional group (P = 0.0001) for AF ablation, and 161 (65, 537) MG group versus 1,651 (796, 4,569) conventional group (P < 0.0001) for AFL ablation. No difference in total procedural time was seen.
  
  
  CONCLUSIONS
  The use of a novel nonfluoroscopic catheter tracking system is associated with a significant reduction in radiation exposure during AF and AFL ablation (61% and 90% reduction, respectively). In the era of heightened awareness of the importance of radiation reduction, this system represents a safe and efficient tool to decrease radiation exposure during electrophysiological ablation procedures.
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Nicolas
authors: N
authors: Malliet
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.|Department of Medicine, The University of British Columbia, Vancouver, Canada.
authors: Jason G
authors: JG
authors: Andrade
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Paul
authors: P
authors: Khairy
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Hien Kiem Nguyen
authors: HK
authors: Thanh
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Sandrine
authors: S
authors: Venier
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Marc
authors: M
authors: Dubuc
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Katia
authors: K
authors: Dyrda
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Peter
authors: P
authors: Guerra
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Blandine
authors: B
authors: Mondésert
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Léna
authors: L
authors: Rivard
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Rafik
authors: R
authors: Tadros
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Mario
authors: M
authors: Talajic
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Bernard
authors: B
authors: Thibault
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Denis
authors: D
authors: Roy
authors: Electrophysiology Service, Montreal Heart Institute, Montreal, Canada.|Department of Medicine, Université de Montréal, Montreal, Canada.
authors: Laurent
authors: L
authors: Macle
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D001282:Atrial Flutter / Q000000981:diagnostic imaging / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis*; D011835:Radiation Protection; D015641:Radiography, Interventional / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
keywords: ICD; ablation; electrophysiology - clinical; surgery