Fluoroless Catheter Ablation of Cardiac Arrhythmias: Change is Inevitable.

The authors report no conflicts of interest for the published content. Address correspondence to: Mansour Razminia, MD, AMITA Health St. Joseph Hospital, 77 North Airlite Street, Elgin, IL 60123, USA. Email: razminia@gmail.com. Historically, fluoroscopy has been an essential tool to facilitate the eradication of cardiac arrhythmias with catheter ablation. However, experience has also shown fluoroscopy to be associated with a number of radiationinduced morbidities, including skin injury, cataract, and malignancies, among others.1–6 Fatal cases of malignancy, for example, have been assessed to occur at rates of 0.7 to 1.4 per 1,000 women and 1.0 to 2.6 per 1,000 men following 50 to 60 minutes of fluoroscopy over the course of catheter ablation procedures.7,8 Other studies have illustrated the significant burden of orthopedic injuries resulting from the regular use of lead protective apparel.9 As an increasing number of patients undergo ablation procedures, efforts to significantly reduce or—ideally—eliminate radiation exposure in patients, operators, and laboratory staff are of paramount importance.