Transcatheter ablation procedures
have been traditionally performed under fluoroscopic guidance. However, x-ray
exposure is afflicted by the risk of developing malignancies as well as other
deterministic effects of radiation. For this reason, radiation doses in the
interventional laboratory should be reduced “As Low As Reasonably Achievable”, with
respect to the safety of the patients and the medical staff. This is of utmost
importance in atrial fibrillation (AF) ablations, which are usually lengthy
procedures. With the improvement of technology, the development of additional
imaging tools and the widespread of 3D electroanatomic mapping systems (EAM),
near-zero fluoroscopy AF ablation procedure is becoming a reality, limiting
fluoroscopy use mainly to guide transseptal puncture.
In the present paper we reviewed
the risks to health related to x-ray exposure and we discussed the current
state of knowledge of catheter ablation of AF without fluoroscopy in the 3D EAM
system era.
Credits: Marco Scaglione, MD; Elisa Ebrille, MD; Francesca Di Clemente, MD; Fiorenzo Gaita, MD