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Utilising electroanatomic mapping during ablation in patients with CHD to reduce radiation exposure

Published online by Cambridge University Press:  18 November 2021

Maryam Rahman*
Affiliation:
The Heart Center, Akron Children’s Hospital, Akron, OH, USA
Jeremy P. Moore
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
John Papagiannis
Affiliation:
Division of Cardiology, Children’s Mercy Hospital, Kansas City, MO, USA
Grace Smith
Affiliation:
The Heart Center, Akron Children’s Hospital, Akron, OH, USA
Chris Anderson
Affiliation:
Center for Congenital Heart Disease, Providence Sacred Heart Children’s Hospital, Spokane, WA, USA
Kevin M. Shannon
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children’s Hospital, Los Angeles, CA, USA
Mansour Razminia
Affiliation:
Clinical Cardiac Electrophysiology, Amita Health Saint Joseph Hospital, Elgin, IL, USA
Volkan Tuzcu
Affiliation:
Department of Pediatric Cardiology/Electrophysiology, Istanbul Medipol University Hospital, Istanbul, Turkey
Neil L. McNinch
Affiliation:
Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, OH, USA
Lisa M. Shauver
Affiliation:
Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, OH, USA
John M. Clark
Affiliation:
The Heart Center, Akron Children’s Hospital, Akron, OH, USA
*
Author for correspondence: M. Rahman, DO, Department of Cardiology, The Heart Center, Akron Children’s Hospital, One Perkins Square, Akron, OH44308, USA. Tel: 330-543-8521; Fax: 330-543-8208. E-mail: mrahman@akronchildrens.org

Abstract

Background:

Patients with CHD can be exposed to high levels of cumulative ionising radiation. Utilisation of electroanatomic mapping during catheter ablation leads to reduced radiation exposure in the general population but has not been well studied in patients with CHD. This study evaluated the radiation sparing benefit of using three-dimensional mapping in patients with CHD.

Methods:

Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy multi-institutional registry. Patients with CHD were selected. Those with previous ablations, concurrent diagnostic or interventional catheterisation and unknown arrhythmogenic foci were excluded. The control cohort was matched for operating physician, arrhythmia mechanism, arrhythmia location, weight and age. The procedure time, rate of fluoroscopy use, fluoroscopy time, procedural success, complications, and distribution of procedures per year were compared between the two groups.

Results:

Fifty-six patients with congenital heart disease and 56 matched patients without CHD were included. The mean total procedure time was significantly higher in patients with CHD (212.6 versus 169.5 minutes, p = 0.003). Their median total fluoroscopy time was 4.4 minutes (compared to 1.8 minutes), and their rate of fluoroscopy use was 23% (compared to 13%). The acute success and minor complication rates were similar and no major complications occurred.

Conclusions:

With the use of electroanatomic mapping during catheter ablation, fluoroscopy use can be reduced in patients with CHD. The majority of patients with CHD received zero fluoroscopy.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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