title: Efficacy and safety of zero-fluoroscopy ablation for supraventricular tachycardias. Use of optional contact force measurement for zero-fluoroscopy ablation in a clinical routine setting.
abstract: BACKGROUND
  Conventional catheter ablation of cardiac arrhythmias is associated with radiation risks for patients and laboratory personnel. Widespread use of zero-fluoroscopic catheter ablation in clinical routine is limited by safety concerns. This study investigated the feasibility of zero-fluoroscopy catheter ablation using a three-dimensional mapping system and optional catheter contact force technology for an all-comers collective.
  
  
  METHODS
  The study comprised 184 patients; 91 patients, including 29 pediatric patients, underwent a zero-fluoroscopic electrophysiology (EP) study using the EnSite NavX system with real-time visualization of all electrodes. These patients were matched to a control group, which was treated using fluoroscopy in the same period. Inclusion criteria were documented supraventricular tachycardia or a history of symptomatic paroxysmal supraventricular tachycardia. Transseptal access, if necessary, was achieved under transesophageal echocardiographic guidance for ablation of left-sided arrhythmias. Radiofrequency (using optional contact force measurement) or a cryotechnique was used for ablation.
  
  
  RESULTS
  We observed no major acute complications. There were no significant differences between the two groups in the follow-up period.
  
  
  CONCLUSIONS
  Zero-fluoroscopic catheter ablation is generally feasible in right-sided cardiac arrhythmias. Safety concerns regarding left atrial substrates or children can be overcome with optional real-time contact force measurement.
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany. peter.seizer@med.uni-tuebingen.de.
authors.forename: P
authors.initials: P
authors.lastname: Seizer
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Bucher
authors.affiliation: Kinderheilkunde II, Pädiatrische Kardiologie, Eberhard Karls University Tuebingen, Tübingen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Frische
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Heinzmann
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gramlich
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Müller
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Henning
authors.affiliation: Kinderheilkunde II, Pädiatrische Kardiologie, Eberhard Karls University Tuebingen, Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hofbeck
authors.affiliation: Kinderheilkunde II, Pädiatrische Kardiologie, Eberhard Karls University Tuebingen, Tübingen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kerst
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Gawaz
authors.affiliation: Medizinische Klinik III, Eberhard Karls University Tuebingen, Universitätsklinikum Tübingen, Ottfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schreieck
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000706:statistics & numerical data*; D017115:Catheter Ablation / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005471:Fluoroscopy; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013314:Stress, Mechanical; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arrhythmia; Catheter ablation; Contact force measurement; Fluoroscopy; Safety