eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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3/2020
vol. 16
 
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abstract:
Original paper

Non-fluoroscopic radiofrequency catheter ablation of right- and left-sided ventricular arrhythmias

Grzegorz Karkowski
1
,
Marcin Kuniewicz
1, 2
,
Edward Koźluk
3
,
Tomasz Chyży
1
,
Andrzej Ząbek
1
,
Michał Dusza
2
,
Jacek Lelakowski
1

  1. Institute of Cardiology, John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland
  2. Jagiellonian University Medical College, Krakow, Poland
  3. 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Adv Interv Cardiol 2020; 16, 3 (61): 321–329
DOI: https://doi.org/10.5114/aic.2020.99268
Online publish date: 2020/10/02
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Introduction
Radiofrequency catheter ablation (RFCA) is an important method of treatment of ventricular arrhythmias (VAs). In the majority of RFCA, fluoroscopy is used, exposing patients and medical staff to all related side effects. Current experience of non-fluoroscopic (NF)-RFCA in VAs from the left side is limited.

Aim
Analysis of safety and effectiveness of NF-RFCA of VAs from left- and right-sided cardiac chambers.

Material and methods
From 2014 to 2018, a group of 128 patients who underwent RFCA of VAs were retrospectively divided into two groups: NF-RFCA and fluoroscopic (F)-RFCA. Patients in each group were then subsequently subdivided into two groups based on VAs localization – left- (LS-Va) and right-sided (RS-Va) VAs. In all patients the CARTO Biosense Webster mapping system was used.

Results
In group 1 (NF-RFCA n = 88) 66 (75%) patients underwent RFCA of RS-Va and 22 (25%) of LS-Va. Early success was achieved in 89.8% (n = 79) and long term success in 81.8% (n = 72). In group 2 (F-RFCA n = 40) 19 patients (47.5%) had RFCA of RS-Va and 21 (52.5%) patients of LS-Va. Acute procedural success rate was 80% (n = 32) and long-term success 72.5% (n = 29). There were 4 (4.6%) perioperative complications in NF-RFCA and 2 (5%) in F-RFCA. Success rate, procedure time and complications were not significantly different between groups and subgroups in follow-up.

Conclusions
NF-RFCA in VAs from the right and left cardiac chamber is safe and equally effective as F-RFCA, and it should be implemented as often as possible for protection of patients and electrophysiology staff.

keywords:

radiofrequency catheter ablation, ventricular arrhythmias, non-fluoroscopic, zero fluoroscopy
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