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Review
. 2020 Mar 15;11(3):4018-4029.
doi: 10.19102/icrm.2020.110305. eCollection 2020 Mar.

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

Ugur Canpolat  1   2 , Michela Faggioni  3 , Domenico G Della Rocca  1 , Qiong Chen  1   4 , Huseyin Ayhan  1   5 , Andrew A Vu  1   6 , Sanghamitra Mohanty  1 , Chintan Trivedi  1 , Carola Gianni  1 , Mohammed Bassiouny  1 , Amin Al-Ahmad  1 , J David Burkhardt  1 , Javier E Sanchez  1 , G Joseph Gallinghouse  1 , Andrea Natale  1   7   8   9   10 , Rodney P Horton  1   11   12
Affiliations
Review

State of Fluoroless Procedures in Cardiac Electrophysiology Practice

Ugur Canpolat et al. J Innov Card Rhythm Manag. .

Abstract

In the past decade, the use of interventional electrophysiological (EP) procedures for the diagnosis and treatment of cardiac arrhythmias has exponentially increased. These procedures usually require fluoroscopy to guide the advancement and frequent repositioning of intracardiac catheters, resulting in both the patient and the operator being subjected to a considerable degree of radiation exposure. Although shielding options such as lead gowns, glasses, and pull-down shields are useful for protecting the operator, they do not lessen the patient's level of exposure. Furthermore, the prolonged use of lead gowns can exponentiate the onset of orthopedic problems among operators. Recent advancements in three-dimensional cardiac mapping systems and the use of radiation-free imaging technologies such as magnetic resonance imaging and intracardiac ultrasound allow operators to perform EP procedures with minimal or even no fluoroscopy. In this review, we sought to describe the state of fluoroless procedures in EP practice.

Keywords: Catheter ablation; electrophysiological study; fluoroscopy; imaging.

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Conflict of interest statement

Dr. Burkhardt is a consultant for Biosense Webster and Stereotaxis. Dr. Natale has received speaker honoraria from Boston Scientific, Biosense Webster, St. Jude Medical, Biotronik, and Medtronic and is a consultant for Biosense Webster, St. Jude Medical, and Janssen. All other authors no conflicts of interest for the published content.

Figures

Figure 1:
Figure 1:
A: The transseptal needle tip is in the desired area (tenting) of the fossa ovalis on ICE. B: Radiofrequency energy is delivered to cross the septum.
See this image and copyright information in PMC

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