Abstract
Abstract Background 3D mapping facilitates zero-fluoro (ZF) and as-low-as-reasonably-achievable (ALARA) procedures which allows for minimizing exposure to harmful radiation and maximizing lead-free time in the EP lab. Objective Safety, efficiency, radiation time and dose exposure was assessed in a consecutive unselected supraventricular tachycardias (SVT) cohort. Methods Retrospective and prospective analysis comparing procedure time, complications and radiation dose and time between ZAP (ZF, ALARA) and non-ALARA cases was performed between January 2021 to August 2022. Radiation exposure was expressed as dose-area product (DAP). We included AVNRTs, accessory pathway (AP) ablations and EP studies. Results A total of consecutive 279 patients were included, of which 116 were ZAP (40 were ZF cases) and 163 non-ALARA. Median age was 52.5 for ZAP and 47.5 for non-ALARA patients. In specific, 131 AVNRT ablations (50 ZAP, 81 non-ALARA), 45 AP ablations (23 ZAP, 22 non-ALARA) and 103 EP studies (43 ZAP, 60 non-ALARA) were included. A comparative analysis of DAP between ZAP and non-ALARA cohort in both AVNRT ablations and EP studies demonstrated statistical significance with corresponding values of 3.15±4.4 vs. 6.04±7.5 Gy.cm2 (p=0.001) and 1.94±1.8 vs. 3.78±3.9 Gy.cm2 (p=0.024) (Figure 1). Significantly shorter fluoroscopy duration was also noted 6.07±6 vs. 12.44±7.5 min (p<0.001; AVNRT) and 4.23±4.2 vs. 6.16±4.1 min (p=0.01; EPS). For AP ablations there was a trend in favour of ZAP but not significant difference (DAP: 8.52±7.7 vs. 10.65±9 Gy.cm2, p=0.43; fluoroscopy duration: 12.12±8.7 vs. 15.9±8.3 min, p=0.33) (Figure 1). This might be attributed to the relatively smaller number of AP cases. Complication rates and procedure time were not different between ZAP and non-ALARA cases. Conclusion Lower fluoroscopy time with reduced radiation exposure is seen in ZAP cases compared to non-ALARA procedures for AVNRT ablations and EP studies. Future ICE navigation in complex cases may further reduce fluoroscopy need.Figure 1
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
