0329: Zero-fluoroscopy ablation for young patients: about 2 cases

Abstract

Radiofrequency catheter ablation (RFA) is the mainstay of therapy for supraventricular arrhythmias. Conventional radiofrequency catheter ablation requires the use of fluoroscopy, exposing patients to ionising radiation. The feasibility and safety of non-fluoroscopic ablation has already been reported using three-dimensional mapping systems. We are reporting 2 cases of young patients, for whom a RFA was performed without using Fluoroscopy. 1 rt Case: A 20-year old patient, presenting dyspnea and palpitation. Physical examination was normal. On ECG, a supraventricular tachycardia (SVT) with long RP and negative P waves in inferior leads was noted. RF ablation was indicated. Catheters were placed in the right atrium without the need to use fluoroscopy, guided by Carto 3D system mapping. The electrophysiology study made the diagnosis of atrial tachycardie arising from the coronary sinus ostium. The foci was successfully ablated. 2 nd Case: A 16-year old patient, consulting for orthodromic reciproting tachycardia. Physical exmination and transthoracic echocardiography were unremarkable. Catheters were placed in the right atrium without the need to use fluoroscopy, guided by Carto 3 D system mapping. Tachycardia was initiated via atrial pacing. An anterograd left lateral accessory pathway was diagnosed. Left atrium was mapped with Carto 3D system through a permeable foramen ovale. The pathway was ablated. Ablation of SVT without use of fluoroscopy has a high acute procedural success rate with low incidence of procedural complication. Use of this technique completely relieves the patient and healthcare of radiation exposure.