Impact of nonfluoroscopic MediGuide™ tracking system on radiation exposure in radiofrequency ablation procedures (LESS-RADS registry)—an initial experience

Abstract

Radiation exposure in the electrophysiology (EP) lab is a major concern to most electrophysiologists. A new technology, MediGuide™ nonfluoroscopic catheter tracking system, has been used for the first time in the USA recently. We intended to evaluate the efficacy of this novel catheter tracking system in reducing radiation exposure. We performed a prospective observational study by comparing the radiation exposure with MediGuide™ system to that of conventional mapping systems. The first 45 EP procedures performed with the MediGuide™ system were compared to 45 matched patients undergoing similar procedures during the same time frame using conventional mapping systems (CARTO and NavX) and fluoroscopy. We collected and compared baseline characteristics, procedural variables including fluoroscopic exposure between both groups. Forty-five patients underwent EP procedures using the MediGuide™ technology. They were matched with an equal number of patients with conventional mapping systems. Of the 45 patients included in the study, 33 underwent right atrial flutter ablations, 5 underwent atrioventricular nodal reentrant tachycardia ablations, 4 underwent ablation of Wolf-Parkinson-White syndrome, and 3 underwent EP studies with no ablation. There were no differences in mean age, gender distribution, and body mass index between the groups. Procedure duration in the MediGuide™ group was significantly lower than the duration in the conventional group (103 vs. 142min, p = 0.03). The fluoroscopic time was significantly less during the procedures performed with the MediGuide™ technology when compared to the control group (8 vs. 21min, p < 0.001). No major complications occurred during the procedures in either group. MediGuide™, a new nonfluoroscopic catheter tracking system, is associated with more than a 50% reduction in fluoroscopic time when compared to conventional mapping systems.