Author + information
- D. Bastian,
- L. Vitali-Serdoz,
- S. Poli,
- J. Walascheck,
- M. Brunelli,
- P. Richter,
- J. Schwab,
- M. Pauschinger,
- H. Rittger and
- K. Göhl
The use of different three-dimensional electro-anatomical mapping (3D-EAM) systems for right-sided arrhythmia ablation may have a distinct effect on procedure duration and radiation exposure.
We evaluated 355 consecutive patients undergoing routine typical atrial flutter ablation at two centers. 267 patients using Carto®3 (Biosense Webster, Diamond Bar, CA) were compared to 88 patients using Ensite NavX/Precision™ (Abbott, SJM, St Paul, MN).
Patients and procedural characteristics are summarized in the Table.
There were no significant differences in age, BMI and procedure duration.
However, the use of different 3-D-EAM resulted in significant differences in fluoroscopy exposure. Ensite™ guided procedures had the lowest X-Ray exposure in term of duration and dose. The success in obtaining a “zero-fluoroscopy” approach was significantly higher in the Ensite™ group (p<0.001). Ensite NavX™ allowed catheter visualization and anatomy acquisition without fluoroscopy beginning directly from the groin. No major complications occurred.
|Typical atrial flutter||Carto ®||Ensite™||P-value|
|Male/Female (%)||200/67 (75/25%)||51/37 (58/42%)|
|Mean age (years)||65.1±12,5||67±14,4||0.23|
|Procedure duration (min)||95.3±48.3||93.4±42.5||0.75|
|Fluoroscopy time (min)||7.1±6.6||0.8±1.9||<0.001|
|No-X-ray procedures, n (%)||46 (17.2%)||56 (65.1%)||<0.001|
BMI body mass index, DAP dose area product
The routine use of 3D-EAM for typical flutter ablation is feasible and effective. The use of Ensite NavX™ is associated with a significant reduction in fluoroscopy and allows a higher percentage of zero fluoroscopy procedures.