Safety, Efficacy and Reduction in Radiation Exposure in Catheter Ablation Procedures Using Localisa System

Abstract

Some fluoroscopic intracardiac navigation systems today allow an important reduction in radiation exposure (RE) during catheter ablation procedures (CAP). To evaluate the benefits obtained by reducing RE during CAP using the LocaLisa®(Medtronic, Minneapolis) (LOCA), a non fluoroscopic system based on Ohm's law. We retrospectively compared the RE time in 2 homogeneous groups of patients (pts) submitted to CAP for atrial tachyarrhythmias. The LOCA group was composed of 80 pts with an average age of 60 years and without organic cardiopathy in 53% of cases. The following CAP was performed: 29 AV node reentrant tachycardias (AVNRT), 38 atrial flutter (AF), 3 AV node ablation (AV), 7 atrial tachycardias (AT). The Control group was composed of an equal number of consecutives and similar procedures were performed as before but without the LOCA system. A further analysis was obtained between two consecutive periods of LOCA utilization (May 2003 and December 2003 first period and January 2004 and February 2005 second period) and Control group. Radiation exposure time – Minutes (mean±SD) (range) No differences were observed between the two periods of LOCA utilization and Control group. The reduction in RE time in the AV group was higher but not statistically significant owing to the limited number of cases. No problems occurred during the CAP with the higher safety of LOCA especially in the identification of the ablation target with the possibility of easier recovery of mapped points before. Our initial experience indicated that the RE was reduced by 50% but we believe that a greater reduction could be obtained by increasing training after an initial period of learning curve. This may represent an extraordinary benefit in RE time reduction due to the increasing CAP volume without reducing the safety and efficacy of the procedures.