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European Heart Journal Advance Access originally published online on March 1, 2005
European Heart Journal 2005 26(14):1415-1421; doi:10.1093/eurheartj/ehi172
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Reduction of fluoroscopy exposure and procedure duration during ablation of atrial fibrillation using a novel anatomical navigation system{dagger}

Martin Rotter, Yoshihide Takahashi, Prashanthan Sanders*, Michel Haïssaguerre, Pierre Jaïs, Li-Fern Hsu, Fréderic Sacher, Jean-Luc Pasquié, Jacques Clementy and Mélèze Hocini

Hôpital Cardiologique du Haut-Lévêque, and Université Victor Segalen Bordeaux 2, Bordeaux, France

Received 27 October 2004; revised 21 December 2004; accepted 20 January 2005; online publish-ahead-of-print 1 March 2005.

* Corresponding author. Tel: +33 557 65 64 71; fax: +33 557 65 65 09. E-mail address: prash.sanders{at}heartrhythm.org

Aims Catheter ablation of atrial fibrillation (AF) is centred on pulmonary vein (PV) ablation with or without additional atrial substrate modification. These procedures may be prolonged with significant fluoroscopy exposure. This study evaluates a new non-fluoroscopic navigation system during ablation of AF.

Methods and results Seventy-two patients undergoing catheter ablation of symptomatic drug refractory AF were prospectively randomized to ablation with (n=35; study group) or without (n=37; control group) non-fluoroscopic navigation. PV isolation was performed in all patients. In patients with persistent or inducible sustained AF after PV isolation linear ablation was performed by joining the superior PVs. PV isolation was achieved in all patients; fluoroscopy (15.4±3.4 vs. 21.3±6.4 min; P<0.001) and procedural (52±12 vs. 61±17 min; P=0.02) durations were significantly reduced in the study group. Linear block was achieved in 37 of the 39 patients; with a significant reduction in fluoroscopy (5.6±2.2 vs. 9.9±4.8 min; P=0.003) and procedural (14.7±5.5 vs. 26.6±16.9 min; P=0.007) durations in the study group. After a follow-up of 6.9±2.9 months (range 3–10), 26 (74%) patients in the non-fluoroscopic navigation group and 29 (78%) patients in the control group were arrhythmia-free after the first procedure.

Conclusion This prospectively randomized study demonstrates significant reduction of fluoroscopy exposure and procedural duration using supplementary non-fluoroscopic imaging system for AF ablation.

Key Words: Atrial fibrillation • Pulmonary vein isolation • Linear ablation • Non-fluoroscopic imaging


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