Comparison of zero fluoroscopy versus fluoroscopy guided ablation for atrial fibrillation: A single center experience

Abstract Funding Acknowledgements Type of funding sources: None. Background With advances in mapping equipment and increased use intracardiac echocardiography (ICE), atrial fibrillation (AF) ablations can be safely performed without fluoroscopy. Benefits include no radiation exposure to patient staff reduced long-term orthopedic complications related lead aprons for staff. Published data comparing zero fluoroscopy ablation (ZFA) conventional guided (CFA) AF is limited small case series meta-analysis. Aim To evaluate the safety procedural outcomes a simplified ZFA approach, it standard care (CFA). Methods Consecutive cases from 03/2021 09/2022 at our institution were included. 120 underwent (RF ablation, ICE 3D guided) 155 CFA (Cryo or RF fluoroscopy, map guided). For group, based relevant anatomical structures was created, order guide trans-septal (TS) access left -sided (See figure) pre-procedural imaging obtained. All had cardiac CT MRI anatomy. Redo represented 17% 23% patients. by operators with >12 years experience, all general anesthesia. Only two required brief period (under 2 min each) achieve safe (including one prior ASD closure device). Results Mean age 67 69 groups respectively (p=NS). 69% 71% men. Persistent more frequently posterior wall isolation group (98% vs 68%, P<0.01), but despite this, times similar both (168±55 172±51 CFA, P=NS). Procedural success (pulmonary vein ± isolation) achieved 99% cases. At mean follow up 12 months, Freedom 81% paroxysmal 74% persistent 79% included TIA pericardial effusions Use antiarrhythmic drugs post did not differ between (23% 27%, p=NS). Conclusion Our approach safe, effective produced compared traditional approach. has considerable health benefits personnel patients compromising outcomes. The cost catheters may offset eliminating need (CT MRI) commonly used ablations. study adds growing literature supporting catheter non-fluoroscopy environment.