Safety and Feasibility of a Minimally Fluoroscopic Approach for Ventricular Tachycardia Ablation in Patients With Structural Heart Disease Influence of the Ventricular Tachycardia Substrate

Data de publicació: 01/02/2016

Autors de IIS La Fe

Óscar Cano Pérez

Autor
Ana Andrés Lahuerta

Autor
Joaquín Osca Asensi

Autor
Pau Alonso Fernández

Autor
María José Sancho-Tello De Carranza

Autor
Jose Olague De Ros

Autor
Luis Vicente Martínez Dolz

Autor

Grups d'Investigació

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí
Regeneración y Trasplante Cardíaco

Leader

Pilar Sepúlveda Sanchis

Abstract

Background- We sought to evaluate the safety and feasibility of a minimally fluoroscopic approach using the CARTOUNIVU module during scar-related ventricular tachycardia (VT) ablation. Methods and Results- Consecutive patients with structural heart disease undergoing VT ablation using the CARTOUNIVU module were prospectively included and classified depending on their VT substrate: (1) ischemic VT (IVT) and (2) nonischemic VT and depending on the presence of an epicardial access. Radiation exposure parameters and major and minor procedure-related complications were registered. A near-zero fluoroscopy exposure was defined as those procedures with an effective dose <= 1 mSv. A total of 44 VT ablation procedures were performed in 41 patients (22 IVT and 19 nonischemic VT). The use of the CARTOUNIVU module resulted in low levels of radiation exposure: median total fluoroscopy time and effective dose of 6.08 (1.51-12.36) minutes and 2.15 (0.58-8.22) mSv, respectively. Patients with IVT had lower radiation exposure than patients with nonischemic VT (total fluoroscopy time, 2.53 [1.22-11.22] versus 8.51 [5.55-17.34] minutes; P=0.016). Epicardial access was associated with significantly higher levels of radiation exposure. Complications occurred in 4.9% patients, none of them being related to the use of the image integration tool. A near-zero fluoroscopy ablation could be performed in 14 of 44 procedures (32%), 43% of IVT procedures, and 50% of procedures with endocardial access only. Conclusions- The use of the CARTOUNIVU module during scar-related VT ablation resulted in low levels of radiation exposure. A near-zero fluoroscopy approach can be achieved in up to half of the procedures, especially in IVT patients with endocardial ablation.

Dades de la publicació

ISSN/ISSNe:: 1941-3149, 1941-3084
Tipus:: Article
Pàgines:: -
DOI:: 10.1161/CIRCEP.115.003706
PubMed:: 26850881
Factor d'Impacte:: 3,545 SCImago ℠
Quartil:: Q1 SCImago ℠

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Mètriques

Filiacions

Cano, O:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain
Andres, A:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Valencia, Spain
Osca, J:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain
Alonso, P:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Valencia, Spain
Sancho-Tello, MJ:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain
Olague, J:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain
Martinez-Dolz, L:: Hosp Univ & Politecn La Fe, Dept Cardiol, Sect Electrophysiol, Valencia 46026, Spain