title: Non-fluoroscopic navigation systems for radiofrequency catheter ablation for supraventricular tachycardia reduce ionising radiation exposure.
abstract: BACKGROUND
  The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time.
  
  
  METHODS
  We prospectively enrolled patients undergoing RFCA for SVT. NFS included EnSiteTM NavXTM or CARTO® mapping. We compared procedure and fluoroscopy times, and radiation exposure between NFS and conventional fluoroscopy (CF) cohorts. Procedural success, complications and one-year success rates were reported.
  
  
  RESULTS
  A total of 200 patients over 27 months were included and RFCA was guided by NFS for 79 patients; those with atrioventricular nodal reentrant tachycardia (AVNRT), left-sided atrioventricular reentrant tachycardia (AVRT) and right-sided AVRT were included (n = 101, 63 and 36, respectively). Fluoroscopy times were significantly lower with NFS than with CF (10.8 ± 11.1 minutes vs. 32.0 ± 27.5 minutes; p < 0.001). The mean fluoroscopic dose area product was also significantly reduced with NFS (NSF: 5,382 ± 5,768 mGy*cm2 vs. CF: 21,070 ± 23,311 mGy*cm2; p < 0.001); for all SVT subtypes. There was no significant reduction in procedure time, except for left-sided AVRT ablation (NFS: 79.2 minutes vs. CF: 116.4 minutes; p = 0.001). Procedural success rates were comparable (NFS: 97.5% vs. CF: 98.3%) and at one-year follow-up, there was no significant difference in the recurrence rates (NFS: 5.2% vs. CF: 4.2%). No clinically significant complications were observed in both groups.
  
  
  CONCLUSIONS
  The use of NFS for RFCA for SVT is safe, with significantly reduced radiation dose and fluoroscopy time.
authors.affiliation: Department of Cardiology, Changi General Hospital, Singapore .
authors.forename: Jason
authors.initials: J
authors.lastname: See
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Jonah L
authors.initials: JL
authors.lastname: Amora
authors.affiliation: Department of Cardiology, Changi General Hospital, Singapore .
authors.forename: Sheldon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Paul
authors.initials: P
authors.lastname: Lim
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Wee Siong
authors.initials: WS
authors.lastname: Teo
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Boon Yew
authors.initials: BY
authors.lastname: Tan
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Kah Leng
authors.initials: KL
authors.lastname: Ho
authors.affiliation: Department of Cardiology, Khoo Teck Puat Hospital, Singapore .
authors.forename: Chee Wan
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore .
authors.forename: Chi-Keong
authors.initials: CK
authors.lastname: Ching
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D011839:Radiation, Ionizing; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000628:therapy; D013617:Tachycardia, Supraventricular / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: non-fluoroscopic systems; radiofrequency catheter ablation; supraventricular tachycardia