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Use of three-dimensional mapping in young patients decreases radiation exposure even without a goal of zero fluoroscopy

Published online by Cambridge University Press:  28 October 2015

Cheyenne Beach ,
Lee Beerman ,
Sharon Mazzocco ,
Maria M. Brooks  and
Gaurav Arora
Cheyenne Beach*
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States of America
Lee Beerman
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States of America
Sharon Mazzocco
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States of America
Maria M. Brooks
Affiliation:
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America
Gaurav Arora
Affiliation:
Division of Pediatric Cardiology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania, United States of America
*
Correspondence to: C. Beach, MD, Children’s Hospital of Pittsburgh of UPMC, One Children’s Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, United States of America. Tel: +412 692 8957; Fax: +412 692 5138; E-mail: cheyenne.beach@chp.edu
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Abstract

At present, three-dimensional mapping is often used during cardiac ablations with an explicit goal of decreasing radiation exposure; three-dimensional mapping was introduced in our institution in 2007, but not specifically to decrease fluoroscopy time. We document fluoroscopy use and catheterisation times in this setting. Data were obtained retrospectively from patients who underwent ablation for atrioventricular nodal re-entrant tachycardia from January, 2004 to December, 2011. A total of 93 patients were included in the study. Among them, 18 patients who underwent radiofrequency ablation without three-dimensional mapping were included in Group 1, 13 patients who underwent cryoablation without three-dimensional mapping were included in Group 2, and 62 patients who underwent cryoablation with three-dimensional mapping were included in Group 3. Mean fluoroscopy times differed significantly (34.3, 23.4, and 20.3 minutes, p<0.001) when all the groups were compared. Group 3 had a shorter average fluoroscopy time that did not reach significance when compared directly with Group 2 (p=0.29). An unadjusted linear regression model showed a progressive decrease in fluoroscopy time (p=0.002). Mean total catheterisation times differed significantly (180, 211, and 210 minutes, p=0.02) and were related to increased ablation times inherent to cryoablation techniques. Acute success was achieved in 89, 100, and 97% of patients (p=0.25), and chronic success was achieved in 80, 92, and 93% of patients (p=0.38). Complication rates were similar (17, 23, and 7%, p=0.14). In conclusion, three-dimensional mapping systems decrease fluoroscopy times even without an explicit goal of zero fluoroscopy. Efficacy and safety of the procedure have not changed.

Keywords

Atrioventricular nodal re-entrant tachycardiaablationthree-dimensional mappingcryoablationradiofrequency
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 7 , October 2016 , pp. 1297 - 1302
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Copyright
© Cambridge University Press 2015 

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