Abstract
Introduction Advances in 3D electroanatomic-mapping technologies have resulted in a safe and effective profile of radiofrequency (RF) catheter ablation. The aim of this study was to evaluate a different catheter ablation approach in patients with left-sided accessory pathways (APs). Methods and results From January 2015 to December 2015, 30 patients (median age 11 years, median weight 45 kg) with manifest or concealed left-sided APs underwent RF catheter ablation with a new protocol. All procedures were performed with the CARTO UNIVU™ system, integrating electroanatomic maps with fluoroscopic views. A 7 Fr ablation catheter was inserted into the right femoral vein and advanced into the right atrium. Geometrical reconstruction and activation map of the right atrium, tricuspid annulus, and coronary sinus were acquired. The ablation catheter was then inserted into the left femoral artery and advanced through the aorta and aortic valve, creating an activation map of the mitral annulus. Catheter ablation was targeted to the site of the earliest activation. No complications occurred. The median procedure and fluoroscopy times were 130 min and 6 s, with a median fluoroscopy dose 0.5 mGy. An average of two catheters was used. Long-term success rate was 97% (29/30) at a median follow-up of 9.6 months. This approach reduced fluoroscopy time, dose and number of catheters used compared with manifest or concealed left-sided AP ablation using CARTO 3™ (P < 0.05). Conclusions This new ablation protocol seems to be promising in reducing fluoroscopy exposure and number of catheters used during left-sided AP ablation in children.
| Original language | English |
|---|---|
| Pages (from-to) | 1198-1203 |
| Number of pages | 6 |
| Journal | Europace |
| Volume | 19 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 1 2017 |
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Keywords
- Ablation
- Children
- Electroanatomical mapping
- Left-sided accessory pathway
- Radiation exposure
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Radiofrequency catheter ablation of left-sided accessory pathways in children using a new fluoroscopy integrated 3D-mapping system. / Drago, Fabrizio; Grifoni, Gino; Remoli, Romolo; Russo, Mario Salvatore; Righi, Daniela; Pazzano, Vincenzo; Palmieri, Rosalinda; Placidi, Silvia; Saputo, Fabio Anselmo; Silvetti, Massimo Stefano.
In: Europace, Vol. 19, No. 7, 01.07.2017, p. 1198-1203.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiofrequency catheter ablation of left-sided accessory pathways in children using a new fluoroscopy integrated 3D-mapping system
AU - Drago, Fabrizio
AU - Grifoni, Gino
AU - Remoli, Romolo
AU - Russo, Mario Salvatore
AU - Righi, Daniela
AU - Pazzano, Vincenzo
AU - Palmieri, Rosalinda
AU - Placidi, Silvia
AU - Saputo, Fabio Anselmo
AU - Silvetti, Massimo Stefano
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Introduction Advances in 3D electroanatomic-mapping technologies have resulted in a safe and effective profile of radiofrequency (RF) catheter ablation. The aim of this study was to evaluate a different catheter ablation approach in patients with left-sided accessory pathways (APs). Methods and results From January 2015 to December 2015, 30 patients (median age 11 years, median weight 45 kg) with manifest or concealed left-sided APs underwent RF catheter ablation with a new protocol. All procedures were performed with the CARTO UNIVU™ system, integrating electroanatomic maps with fluoroscopic views. A 7 Fr ablation catheter was inserted into the right femoral vein and advanced into the right atrium. Geometrical reconstruction and activation map of the right atrium, tricuspid annulus, and coronary sinus were acquired. The ablation catheter was then inserted into the left femoral artery and advanced through the aorta and aortic valve, creating an activation map of the mitral annulus. Catheter ablation was targeted to the site of the earliest activation. No complications occurred. The median procedure and fluoroscopy times were 130 min and 6 s, with a median fluoroscopy dose 0.5 mGy. An average of two catheters was used. Long-term success rate was 97% (29/30) at a median follow-up of 9.6 months. This approach reduced fluoroscopy time, dose and number of catheters used compared with manifest or concealed left-sided AP ablation using CARTO 3™ (P < 0.05). Conclusions This new ablation protocol seems to be promising in reducing fluoroscopy exposure and number of catheters used during left-sided AP ablation in children.
AB - Introduction Advances in 3D electroanatomic-mapping technologies have resulted in a safe and effective profile of radiofrequency (RF) catheter ablation. The aim of this study was to evaluate a different catheter ablation approach in patients with left-sided accessory pathways (APs). Methods and results From January 2015 to December 2015, 30 patients (median age 11 years, median weight 45 kg) with manifest or concealed left-sided APs underwent RF catheter ablation with a new protocol. All procedures were performed with the CARTO UNIVU™ system, integrating electroanatomic maps with fluoroscopic views. A 7 Fr ablation catheter was inserted into the right femoral vein and advanced into the right atrium. Geometrical reconstruction and activation map of the right atrium, tricuspid annulus, and coronary sinus were acquired. The ablation catheter was then inserted into the left femoral artery and advanced through the aorta and aortic valve, creating an activation map of the mitral annulus. Catheter ablation was targeted to the site of the earliest activation. No complications occurred. The median procedure and fluoroscopy times were 130 min and 6 s, with a median fluoroscopy dose 0.5 mGy. An average of two catheters was used. Long-term success rate was 97% (29/30) at a median follow-up of 9.6 months. This approach reduced fluoroscopy time, dose and number of catheters used compared with manifest or concealed left-sided AP ablation using CARTO 3™ (P < 0.05). Conclusions This new ablation protocol seems to be promising in reducing fluoroscopy exposure and number of catheters used during left-sided AP ablation in children.
KW - Ablation
KW - Children
KW - Electroanatomical mapping
KW - Left-sided accessory pathway
KW - Radiation exposure
UR - http://www.scopus.com/inward/record.url?scp=85026403625&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026403625&partnerID=8YFLogxK
U2 - 10.1093/europace/euw220
DO - 10.1093/europace/euw220
M3 - Article
AN - SCOPUS:85026403625
VL - 19
SP - 1198
EP - 1203
JO - Europace
JF - Europace
SN - 1099-5129
IS - 7
ER -