Fluoroscopy integration module reduces radiation exposure without affecting procedure time in accessory pathway ablation

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Conventional Accessory Pathway (AP) ablation is a straightforward approach with high success rates, but the fluoroscopy time is significantly higher. Electroanatomical mapping systems (EMS), reduce the fluoroscopy time, but anatomical reconstruction and activation mapping prolong the procedure time. The Fluoroscopy Integration Module (FIM) uses prerecorded fluoroscopy images and allows ablation similar to conventional technique without creating an anatomical map. In this study, we investigated the effects of combining the FIM with the traditional technique on procedure time, success, and radiation exposure. Methods 112 patients who underwent AP ablation were included in our study. In 18 patients, right and left anterior oblique (RAO -LAO) images were recorded after the insertion of the catheters and integrated with FIM. Afterwards, ablation was performed similarly to the conventional technique but without using fluoroscopy. To accelerate the procedure anatomical and activation maps were not created. Contact-force catheters were not used. 94 patients were ablated conventionally using only fluoroscopy. Results Combining the FIM with the conventional method significantly reduced radiation exposure (Fluoroscopy time: 3,3±2,6 vs 11,5±11,6 sec, p: 0,001; Dose-area-product (DAP): 7,3±6,2 vs. 28,6±40,5 μGym2, p: 0,003) without affecting the total procedure time ( 64,4±15 vs. 62,6±28,7 sec, p: 0,272 ), time to successful ablation ( 33,2±13,9 vs. 29,7±29,5 sec p: 0,056) and radiofrequency application time ( 183,7±94,4 vs. 167,3±89,8 sec p: 0,336). Conclusion These findings suggest that FIM can be used for rapid and successful ablation of APs with reduced radiation exposure times.