Introduction: The zero-fluoroscopic approach for the catheter ablation of the cavotricuspid isthmus (CA-ICT) is feasible and safe. The influence of the 3D-anatomical reconstruction of the right atrium (3D-RA) on the results of this procedure has not been studied yet.
Methods: One hundred and seventy nine (174) procedures of CA-ICT performed with zero-fluoroscopic approach as a first line of treatment were analyzed. An open-irrigated ablation catheter was used in all the procedures; bidirectional block was used as the end-point of the procedure.
In 69 procedures (39.7%) the 3D-RA was carried out at the discretion of the attending staff. Forty-six (66.7%) 3D-RA were performed by the Ensite-NavXTM system and 23 (33.3) by the Carto3® system.
The non-fluoroscopic navigation system and the use of two diagnostic catheters were related with the 3D-RA.
The procedures with 3D-RA were longer (157±49 vs. 127±42 minutes) because a longer diagnostic procedures (82±33 vs. 57±36 minutes). The 3D-RA had not influence on the percentage of neither success nor complications. The use of fluoroscopy was not increased by the 3D-RA. The radiofrequency time was shorter in those procedures performed with 3D-RA (13±12 vs. 17±17 minutes).
Conclusions: The tridimensional reconstruction of the right atrium in the zero-fluoroscopic approach of the cavotricuspid-isthmus catheter ablation prolongs the length of the procedure and reduces the radiofrequency time. Other variables (success, complications and need of fluoroscopic) were not influenced.