Long-term outcomes after “Zero X-ray” arrhythmia ablation

  • Marzia Giaccardi
  • Giuseppe MasciaEmail author
  • Alessandro Paoletti Perini
  • Andrea Giomi
  • Stella Cartei
  • Massimo Milli



Radiation exposure related to conventional tachyarrhythmia radiofrequency catheter ablation (RFCA) carries small but definite risk for both patients and operators. Today, non-fluoroscopic mapping systems enable to perform catheter ablation with minimal or zero fluoroscopy. The purpose of this study was to evaluate the long-term outcome of patients who had undergone “Zero X-ray” ablation, since no information is available on the very long-term benefits.


A total of 272 arrhythmias in 266 patients have been treated with catheter ablation by means of a zero-ray approach guided only by a nonconventional mapping system (EnSite NavX™, Ensite™ Velocity™ mapping system; subsequently Ensite™ Precision™ Abbott, St. Paul, MN). Fluoroscopy was never used.


Over a period of 6 years, patients were followed up for an average of 2.9 ± 1.6 years. A 100% rate of acute success was observed in the study population, with a complication rate of 0.8%. Chronic success was achieved in 90.8% of the total number of procedures (272). Patients in whom the same arrhythmia recurred during follow-up underwent to a redo catheter ablation procedure in 60.0% of cases, while the remaining 40.0% underwent pharmacological treatment. A new post-ablation arrhythmia occurred in 7.7% of the sample.


The non-fluoroscopic approach is a feasible and safe alternative to fluoroscopy for arrhythmias ablation. This method ensures low complications rates, high acute procedural success rates, and comparable long-term outcomes with clinical benefits for both patients and physicians. The complete elimination of fluoroscopy during catheter ablation is advantageous and does not reduce patient safety.


Arrhythmia Catheter ablation Radiation risk Zero fluoroscopy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cardiology Unit and Electrophysiology Unit, Department of Internal MedicineSanta Maria Nuova HospitalFlorenceItaly
  2. 2.Electrophysiology Unit, Casa di Cura MontevergineMercoglianoItaly

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