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Fluoroscopy-free ablation in congenital heart disease of moderate or great complexity

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Fluoroscopy-free (FF) ablation has been demonstrated to be safe and successful in patients with structurally normal hearts, but has not been systematically evaluated in patients with congenital heart disease (CHD) of moderate or great (M/G) complexity. This study aimed to evaluate and compare feasibility, safety, and outcomes of FF ablation in patients with or without M/G-CHD.

Methods

Consecutive patients undergoing electrophysiologic study and intended catheter ablation over a 24-month period were included. Subgroups were created based on presence and complexity of CHD–M/G-CHD or simple complexity/no CHD (S/N-CHD). Cases with total radiation dose of zero qualified as FF. Demographic and peri-procedural variables and outcome data were analyzed.

Results

A total of 89 procedures were included with 62 comprising the S/N-CHD group and 27 comprising the M/G-CHD group. Of the M/G-CHD patients, 13 had CHD of great complexity (including 6 single ventricle/Fontan and 2 atrial switch patients). Patients with M/G-CHD were older, had higher BMI, had higher incidence of ventricular dysfunction, and greater incidence of complex arrhythmias. Fluoroscopy-free ablation was achieved in 59% of M/G-CHD and 69% of S/N-CHD patients. Both groups had similar rates of acute procedural success, recurrence, and complications. Fluoroscopy was primarily used to visualize pre-existing transvenous leads and peripheral venous anomalies or to guide transbaffle/transseptal puncture.

Conclusions

A fluoroscopy-free ablation approach is feasible, safe, and successful even in patients with M/G-CHD with comparable outcomes to those with S/N-CHD.

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Authors and Affiliations

  1. Congenital Heart Center, University of Florida, 1600 SW Archer Rd, P.O. Box 100296, Gainesville, FL, 32610, USA

    Arjun K. Mahendran, Sara Bussey & Philip M. Chang

Authors
  1. Arjun K. Mahendran
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  2. Sara Bussey
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Correspondence to Arjun K. Mahendran.

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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of University of Florida approved this study.

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The authors declare no competing interests.

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Mahendran, A.K., Bussey, S. & Chang, P.M. Fluoroscopy-free ablation in congenital heart disease of moderate or great complexity. J Interv Card Electrophysiol 63, 611–620 (2022). https://doi.org/10.1007/s10840-021-01079-8

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  • DOI: https://doi.org/10.1007/s10840-021-01079-8

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