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The effect of NavX on fluoroscopy times in pediatric catheter ablation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Catheter ablation is the established curative therapy for pediatric tachyarrhythmias. However, exposure to ionizing radiation from fluoroscopy during the procedure is of concern to both patients and caregivers. We sought to assess the impact of an impedance-based three-dimensional navigation system (NavXTM, Endocardial Solutions, Inc., St. Paul, MN) on pediatric catheter ablation procedures.

Methods

We retrospectively analyzed procedural data during a 7-year period (2002–2008), which spanned the transition between standard fluoroscopic mapping and adoption of NavXTM mapping for catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) and right/left-sided accessory pathways (RAP/LAP). Comparisons of total procedure time, total fluoroscopy time, and ablation fluoroscopy time (from insertion of ablation catheter until completion of procedure) between NavXTM and conventional mapping were made.

Results

Three hundred eighty-eight patients (aged 1–18 years, M/F 236:183) underwent ablation of AVNRT (n = 101), LAP (n = 130), or RAP (n = 157) using either conventional (n = 70) or NavXTM (n = 318) mapping. Overall success rates were similar between the two mapping approaches (95.7% for conventional versus 95.9% for NavXTM). NavXTM mapping significantly reduced ablation fluoroscopy time (15.9 ± 14.3 versus 11.0 ± 8.9 min for NavXTM, p < 0.01) with a trend towards a decrease in total fluoroscopy time (26.4 ± 15.6 versus 23.8 ± 11.1 min for NavXTM, p = 0.095). Total procedure time was not significantly different between the two methods (210.1 ± 66 versus 222.8 ± 61 min for NavXTM, p = 0.13). When analyzed by arrhythmia substrate, there were significant reductions in ablation fluoroscopy time for both LAP and RAP.

Conclusions

NavXTM mapping reduced ablation fluoroscopy times for accessory pathways during pediatric catheter ablation.

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Authors and Affiliations

  1. Department of Pharmacology, University of Toronto, Toronto, ON, Canada

    Wilson Kwong

  2. St. Jude Medical, St Paul, MN, USA

    Andrea L. Neilson & Luc Soucie

  3. The Labatt Family Heart Centre, Hospital for Sick Children, 555 University Ave., Room 1725, M5G 1X8, Toronto, ON, Canada

    Christine C. Chiu, Gil J. Gross, Robert M. Hamilton, Elizabeth A. Stephenson & Joel A. Kirsh

  4. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Gil J. Gross, Robert M. Hamilton, Elizabeth A. Stephenson & Joel A. Kirsh

Authors
  1. Wilson Kwong
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  2. Andrea L. Neilson
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  3. Christine C. Chiu
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  4. Gil J. Gross
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  5. Robert M. Hamilton
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  6. Luc Soucie
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  7. Elizabeth A. Stephenson
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  8. Joel A. Kirsh
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Corresponding author

Correspondence to Joel A. Kirsh.

Additional information

Andrea Neilson was at the Labatt Family Heart Centre during the initial data collection and analysis for this study.

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Kwong, W., Neilson, A.L., Chiu, C.C. et al. The effect of NavX on fluoroscopy times in pediatric catheter ablation. J Interv Card Electrophysiol 33, 123–126 (2012). https://doi.org/10.1007/s10840-011-9604-y

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  • DOI: https://doi.org/10.1007/s10840-011-9604-y

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