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3D navigation system allows remarkable reduction in fluoroscopy use during cavo-tricuspid isthmus ablation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Typical atrial flutter (AFL) is one of the most common supraventricular arrhythmias. Its treatment mainly relies on cavo-tricuspid isthmus (CTI) ablation, which can be performed either using conventional fluoroscopy, still mainly used, or 3D navigation system to track the position of the catheter. The aim of this study is to show that the use of a 3D navigation system allows a dramatic reduction of fluoroscopy use during CTI ablation, without any loss of efficacy, time, or safety.

Methods

In this single-center study, we retrospectively compared 134 cases of CTI ablation performed for typical AFL without a 3D navigation system with 95 cases of CTI ablation performed with such a 3D system. We compared the rates of procedural success (defined as obtaining a bidirectional electrical conduction block), freedom from AFL recurrence at 1-year follow-up, procedural time and safety, and fluoroscopy use.

Results

Compared to conventional fluoroscopy, the use of a 3D navigation system significantly decreased the duration of fluoroscopy use (2 min 13 s ± 2 min 16 s versus 14 min 41 s ± 10 min 39 s, p < 0.0001) and dose-area products (1567.9 ± 1329.5 mGy cm2 versus 8263.3 ± 8636.6 mGy cm2, p < 0.0001). Procedure success rates, duration, and safety were not different between groups.

Conclusions

The use of 3D navigation during CTI ablation substantially reduces fluoroscopy use duration, without reducing the success rates and safety or prolonging the procedure duration, as compared to conventional fluoroscopy. We therefore suggest the generalization of this navigation system.

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References

  1. Brugada J, Katritsis DG, Arbelo E, et al. ESC Scientific Document Group, 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2020;41(5):655–720. https://doi.org/10.1093/eurheartj/ehz467.

    Article  PubMed  Google Scholar 

  2. Natale A, Newby KH, Pisano E, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol. 2000;35:1898–904.

    Article  CAS  Google Scholar 

  3. Schwartzman D, Callans DJ, Gottlieb CD, Dillon SM, Movsowitz C, Marchlinski FE. Conduction block in the inferior vena caval-tricuspid valve isthmus: association with outcome of radiofrequency ablation of type I atrial flutter. J Am Coll Cardiol. 1996;28:1519–31.

    Article  CAS  Google Scholar 

  4. Javier Garcia-Fernandez F, Criado JLI, Dorador AQ, on behalf of the collaborators of the Spanish Catheter Ablation Registry. Spanish Catheter Ablation Registry. 17th Official Report of the Spanish Society of Cardiology Working Group on Electrophysiology and Arrhythmias (2017). Rev Esp Cardiol. 2018;71(11):941–51.

    Article  Google Scholar 

  5. Holmqvist F, Kesek M, Englund A, et al. A decade of catheter ablation of cardiac arrhythmias in Sweden: ablation practices and outcomes. Eur Heart J. 2019;40(10):820–30. https://doi.org/10.1093/eurheartj/ehy709.

    Article  PubMed  Google Scholar 

  6. Brachmann J, Lewalter T, Kuck K-H, et al. Long-term symptom improvement and patient satisfaction following catheter ablation of supraventricular tachycardia: insights from the German ablation registry. Eur Heart J. 2017;38(17):1317–26. https://doi.org/10.1093/eurheartj/ehx101.

    Article  PubMed  Google Scholar 

  7. Zhang T, Wang Y, Han Z, Zhao H, Liang Z, Wang Y, et al. Cavotricuspid isthmus ablation using ablation index in typical right atrial flutter. J Cardiovasc Electrophysiol. 2019;30:2414–9. https://doi.org/10.1111/jce.14156.

    Article  PubMed  Google Scholar 

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Funding

The authors did not receive any grant or financial support.

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Authors and Affiliations

  1. Department of Cardiology, Université catholique de Louvain, CHU UCL Namur – Cliniques universitaire de Mont-Godinne, Av Dr G Therasse, 1, 5530, Yvoir, Belgium

    Benoit Robaye, Olivier Deceuninck, Dominique Blommaert, Véronique Godeaux, Fabien Dormal, Benoit Collet, Elisabeth Ballant, Florence Huys, Antoine Guedes & Olivier Xhaët

  2. Department of Cardiology, CHR Namur, 5000, Namur, Belgium

    Olivier Deceuninck

Authors
  1. Benoit Robaye
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  2. Olivier Deceuninck
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  3. Dominique Blommaert
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  4. Véronique Godeaux
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  5. Fabien Dormal
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  6. Benoit Collet
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  7. Elisabeth Ballant
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  8. Florence Huys
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  9. Antoine Guedes
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  10. Olivier Xhaët
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Corresponding author

Correspondence to Benoit Robaye.

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The authors declare that they have no conflict of interest.

Ethics approval

The study protocol was approved by the local institutional ethics committee (internal local ethic committee submission number 66/2020).

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Cite this article

Robaye, B., Deceuninck, O., Blommaert, D. et al. 3D navigation system allows remarkable reduction in fluoroscopy use during cavo-tricuspid isthmus ablation. J Interv Card Electrophysiol 61, 333–338 (2021). https://doi.org/10.1007/s10840-020-00818-7

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  • DOI: https://doi.org/10.1007/s10840-020-00818-7

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