Ablation of idiopathic ventricular arrhythmia using zero-fluoroscopy approach with equivalent efficacy and less fatigue: A multicenter comparative study.
The efficacy of a completely zero-fluoroscopy (ZF) approach for the catheter ablation of idiopathic ventricular arrhythmias (VAs) and whether it has advantages over the conventional fluoroscopy (F) approach are still unknown. The aim of this study was to compare the safety and efficacy of a completely ZF approach with those of the conventional F approach in the ablation of idiopathic VAs.We conducted a prospective study involving 7 centers in China. Consecutive patients (n = 489, mean age 45.3 ± 15.3 years, 44.8% male) with idiopathic VAs were recruited. Eligible participants were assigned to either a ZF (n = 163) or F (n = 326) approach at a ratio of 1:2. The completely ZF approach was successful in 163 (100%) patients for electrophysiological study, and in 151 patients (94.4%) for arrhythmia ablation with 9 cases having to switch to the F approach due to the need for coronary angiography. There was no significant difference between the ZF approach and F approach in procedural success rate (84.1% vs 85.4%, respectively), arrhythmia recurrence (1.9% vs 2.2%), or severe complications (0.6% vs 0.9%). The medical staffs using the ZF approach did not wear heavy protective apparels, thus experienced significantly less fatigue compared with those using the F approach (2.1 ± 0.7 vs 3.9 ± 1.6, P < 0.05).The completely ZF approach is as safe and efficient as the conventional F approach for the electrophysiological study and the ablation of idiopathic VAs. The medical staffs using ZF approach felt less fatigue and received less exposure to radiation.
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Clinical EP Laboratory and Arrhythmia Center, Fuwai Hospital and Cardiovascular Institute, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing Department of Cardiology, First Hospital of Ningbo City, Ningbo Department of Cardiology, Xiangyang Central Hospital, Xiangyang, P.R. China Duke-NUS Graduate Medical School, Singapore Cardiovascular Department, First Affiliated Hospital of Guangxi Medical University, Nanning Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou Sun Yat-sen Cardiovascular Hospital, Shenzhen, P.R. China.
Yan
Y
Wang
Guang Zhi
GZ
Chen
Yan
Y
Yao
Yang
Y
Bai
Hui Min
HM
Chu
Ke Zhong
KZ
Ma
Reginald
R
Liew
Hao
H
Liu
Guo Qiang
GQ
Zhong
Yu Mei
YM
Xue
Shu Lin
SL
Wu
Yi Fu
YF
Li
Chun Xia
CX
Zhao
Qi Gong
QG
Liu
Li
L
Lin
Lin
L
Wang
Dao Wen
DW
Wang
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002681:China; D005221:Fatigue / Q000209:etiology; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies