Zero Fluoroscopy Ablation: Recent Trends in Radiation Exposure in the EP Lab

  • Chris Anderson
  • Alaina R. Martinez
  • Mansour Razminia
  • John ClarkEmail author
Cardiology/CT Surgery (K Gist, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardiology/CT Surgery


Purpose of review

Catheter ablation procedures involve fluoroscopy and can result in significant radiation exposure to the patient and staff. From the early 1980s to 2006, there was a 600% increase in the average medical radiation dose per person per year in the USA. Toward the end of this time frame, three-dimensional (3D) mapping systems, which use magnetic or electrical fields to track catheter location and movement, became clinically available. This has allowed reduction in fluoroscopy use. The goal of this manuscript is to review the current state of zero fluoroscopy ablations.

Recent findings

In the early 2000s, the first report of a 3D mapping system, used to replace fluoroscopy, emerged. By 2015, centers were routinely performing fluoroless ablations. Today, most centers use these systems to decrease radiation exposure. Multi-center registries now exist to quantify the changes in patient care.


Increased radiation exposure is associated with increased long-term risk of cancer. Today’s 3D mapping systems allow most ablation procedures to be performed without the use of fluoroscopy. With further refinements in the available tools, coupled with increasing operator experience, radiation exposure will be eliminated for all routine ablation procedures.


Ablation Fluoroscopy Radiation Three-dimensional mapping SVT Tachycardia 


Compliance with Ethical Standards

Conflict of Interest

Chris Anderson declares that he has no conflict of interest. Alaina R. Martinez declares that she has no conflict of interest. Mansour Razminia is a consultant for Abbott. John Clark declares that he has no conflict of interest.

Human and animal rights and informed consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Chris Anderson
    • 1
  • Alaina R. Martinez
    • 2
  • Mansour Razminia
    • 3
  • John Clark
    • 4
    Email author
  1. 1.Center for Congenital Heart DiseaseProvidence Sacred Heart Children’s HospitalSpokaneUSA
  2. 2.Rebbecca D. Considine Research InstituteAkron Children’s HospitalAkronUSA
  3. 3.Clinical Cardiac ElectrophysiologyAmita HealthElginUSA
  4. 4.The Heart CenterAkron Children’s HospitalAkronUSA

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