Advances in Catheter Ablation of Atrial Fibrillation: Near-Zero Fluoroscopy

Abstract

The effects associated with ionizing radiation exposure have been well established and have provided the motivation to develop a minimal fluoroscopic approach (MFA) to reduce radiation exposure without compromising efficacy and safety. This review summarizes the current literature on the outcomes and safety of MFA for catheter ablation treatment of atrial fibrillation (AF) and outlines our workflow for catheter ablation of AF with MFA. Our review of the current literature shows that with the use of advanced electroanatomic mapping systems and intracardiac echocardiography, catheter ablation of AF performed with MFA results in significant reductions in radiation exposure without increases in procedural times or complication rates. With adoption of a proper mindset to minimize fluoroscopy usage by utilizing currently available electroanatomic mapping and imaging tools, catheter ablation of AF with zero or minimal fluoroscopy can be readily performed.