Zero-fluoro AVNRT ablation

Abstract Background Atrioventricular-nodal reentry tachycardia (AVNRT) is a common supraventricular tachycardia, particularly in younger patients. First-line therapy symptomatic patients radiofrequency catheter ablation (RFCA). Catheter placement and are typically performed by fluoroscopy guidance implying non-negligible exposure of ionizing radiation for patient laboratory personnel. Purpose We aimed to demonstrate feasibility safety AVNRT using 3D-electroanatomic mapping (3D-EAM) as sole additional means compared conventional fluoroscopic positioning. Endpoints were: procedure duration, dose occurrence any complication. Methods retrospectively included consecutive (n=68, mean age 55±18 years) who underwent RFCA between 01/2020 12/2021 our hospital. One group was priori allocated (convFluoro, n=30), the other procedures were under 3D-EAM Ensite NavX (NavX). From latter, slow-pathway could be without (zeroFluoro) 20 patients, 18 cases additionally used due difficult anatomic conditions (NavX+Fluoro). Success defined elimination. Results There no significant difference duration convFluoro overall (74±24 min vs. 87±29 min, P=NS). However, NavX+Fluoro (comprising more complicated cases) had longer (94±30 74±24 p<0.05). The use significantly reduced comparing with (12±9 7±6 p<0.05) NavX-group 3±5 p<0.0001). Likewise, decreased (NavX: 60±113 cG cm2 convFluoro: 169±166 cm2, p<0.01). guided successful all (100%), success rate convFluoro-group 87% (P=NS). Minor complications occurred two (7%) 4 (11%) No severe complication, such pericardial effusion or permanent AV-block group. Conclusion Zero-fluoroscopy 3D-EAM-guided feasible safe. Without prolonging can reduce leading lower making electrophysiological study safer staff Funding Acknowledgement Type funding sources: None.