title: Fluoroless catheter ablation in adults: a single center experience.
abstract: BACKGROUND
  Ablation procedures for arrhythmias have increased in frequency and complexity over the last decade. Improvements in technology have allowed for less reliance on fluoroscopy to guide these procedures. Ablation without fluoroscopy has been reported in small cohorts. We report a single center experience of fluoroless ablation after adoption of this technique for all endovascular ablations.
  
  
  METHODS
  This retrospective study evaluated 107 consecutive patients who underwent a catheter ablation procedure for an atrial or ventricular arrhythmias after adoption of a completely fluoroless technique. No fluoroscopy was used in any case. A mapping system was utilized in all cases. Intracardiac echocardiography (ICE) catheters were utilized in 75 of the ablation cases (70.4%). Of the 107 patients who underwent EP study, three patients did not undergo ablation as they were non-inducible for SVT. Of the remaining 104 patients, 56 patients (53.8%) underwent ablation for atrial fibrillation, 23 patients (22.1%) for SVT, 10 patients (9.6%) for lone atrial flutter, and 16 patients (15.4%) for a ventricular arrhythmia including PVC, idiopathic VT or ventricular tachycardia.
  
  
  RESULTS
  Catheters were able to be placed in 100% of patients without complication. Time to placement in the coronary sinus was 2.1 min ± 1.4 min. Mean transseptal time was 3.54 min ± 3 min. Mean procedure time for all ablations was 2 h 6 min ± 50 min. There were no complications in the series of patients.
  
  
  CONCLUSIONS
  Fluoroless ablation is feasible and safe with acceptable procedure times. Adoption of this technique is encouraged in order to eliminate unnecessary risk of fluoroscopy.
authors.affiliation: Division of Cardiac Electrophysiology, The Heart Health Center, 450 North New Ballas Road West Wing 270, Saint Louis, MO, 63141, USA. Jsanchez@hearthealthcenter.com.
authors.forename: J Mauricio
authors.initials: JM
authors.lastname: Sánchez
authors.affiliation: Division of Cardiac Electrophysiology, Mercy Heart and Vascular, Saint Louis, MO, 63141, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Yanics
authors.affiliation: Division of Cardiac Electrophysiology, Mercy Heart and Vascular, Saint Louis, MO, 63141, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Wilson
authors.affiliation: Division of Cardiac Electrophysiology, Mercy Heart and Vascular, Saint Louis, MO, 63141, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Doshi
authors.affiliation: Division of Cardiac Electrophysiology, Mercy Heart and Vascular, Saint Louis, MO, 63141, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kurian
authors.affiliation: Division of Cardiac Electrophysiology, The Heart Health Center, 450 North New Ballas Road West Wing 270, Saint Louis, MO, 63141, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Pieper
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Ablation; Atrial fibrillation; Atrial flutter; Fluoroless; PVC; SVT; Ventricular tachycardia