PMID- 25736724
OWN - NLM
STAT- MEDLINE
DCOM- 20160323
LR  - 20220311
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 17
IP  - 7
DP  - 2015 Jul
TI  - Ablation of typical atrial flutter using a non-fluoroscopic catheter tracking 
      system vs. conventional fluoroscopy--results from a prospective randomized study.
PG  - 1117-21
LID - 10.1093/europace/euu398 [doi]
AB  - AIMS: Reduction of radiation exposure using a sensor-based non-fluoroscopic 
      catheter tracking (NFCT) system (MediGuide, St Jude Medical, Inc.) was recently 
      demonstrated by retrospective comparisons. We aimed to prospectively compare the 
      effects of using NFCT vs. standard fluoroscopy on procedural parameters in 
      patients undergoing radiofrequency ablation of typical atrial flutter. METHODS 
      AND RESULTS: We prospectively randomized 40 patients undergoing cavotricuspid 
      isthmus ablation for typical atrial flutter to either NFCT (n = 20) or 
      conventional fluoroscopy (CONV, n = 20). Procedural parameters such as 
      fluoroscopy time, radiation dose, and procedure duration, as well as 
      periprocedural complications were compared. There were no statistically 
      significant differences in baseline characteristics between the two groups. 
      Bidirectional isthmus block was achieved in all patients. Fluoroscopy time was 
      significantly reduced in the NFCT group 0.3 [inter-quartile range (IQR) 0.2; 
      0.48] min when compared with CONV [5.7 (IQR 4.2; 11.5) min] (P < 0.001). This 
      resulted in a significant reduction in radiation dose in patients randomized to 
      NFCT [17.4 (IQR 11; 206.6) cGy cm(2)] vs. the CONV group [418.4 (IQR 277; 812.2) 
      cGy cm(2)] (P < 0.001). There were no significant differences in procedure 
      duration between the NFCT group [49.5 (IQR 37; 65) min] when compared with the 
      CONV group [33.5 (IQR 26.3; 55.5) min] (P = 0.053). No adverse events were 
      recorded. Freedom from atrial flutter at 6 months of follow-up was 19/20 (95%) in 
      the NFCT and 18/20 (90%) in the CONV group (n.s.). CONCLUSION: In this first 
      prospective randomized study, by comparing NFCT with standard fluoroscopy in 
      patients undergoing radiofrequency ablation of typical atrial flutter, NFCT 
      significantly reduced both radiation dose and fluoroscopy time with no effects on 
      procedural duration. These findings support the incorporation of NFCT in routine 
      clinical use.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2015. For permissions please email: journals.permissions@oup.com.
FAU - Schoene, Katharina
AU  - Schoene K
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany schoene_katha@t-online.de.
FAU - Rolf, Sascha
AU  - Rolf S
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Schloma, Denis
AU  - Schloma D
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - John, Silke
AU  - John S
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Arya, Arash
AU  - Arya A
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Dinov, Borislav
AU  - Dinov B
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Richter, Sergio
AU  - Richter S
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Bollmann, Andreas
AU  - Bollmann A
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Hindricks, Gerhard
AU  - Hindricks G
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
FAU - Sommer, Philipp
AU  - Sommer P
AD  - Heart Center, Department of Electrophysiology, University of Leipzig, 
      Struempellstrasse 39, Leipzig 04289, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20150303
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - Atrial Flutter/*diagnosis/*surgery
MH  - *Cardiac Catheters
MH  - Electromagnetic Fields
MH  - Equipment Design
MH  - Equipment Failure Analysis
MH  - Female
MH  - Fluoroscopy/*instrumentation/methods
MH  - Germany
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Radiation Dosage
MH  - Radiation Protection/methods
MH  - Surgery, Computer-Assisted/*instrumentation
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Ablation
OT  - Non-fluoroscopic tracking system
OT  - Radiation time
OT  - Typical atrial flutter
EDAT- 2015/03/05 06:00
MHDA- 2016/03/24 06:00
CRDT- 2015/03/05 06:00
PHST- 2014/09/08 00:00 [received]
PHST- 2014/12/15 00:00 [accepted]
PHST- 2015/03/05 06:00 [entrez]
PHST- 2015/03/05 06:00 [pubmed]
PHST- 2016/03/24 06:00 [medline]
AID - euu398 [pii]
AID - 10.1093/europace/euu398 [doi]
PST - ppublish
SO  - Europace. 2015 Jul;17(7):1117-21. doi: 10.1093/europace/euu398. Epub 2015 Mar 3.