Radiation exposure reduction during atrial fibrillation ablation in real-life population using fluoroscopy and 3D mapping system integration

Introduction. Fluoroscopy integration with three dimensional (3D) electroanatomical mapping system may allow dose reduction while invasive electrophysiological procedures. In this retrospective study we present real-population experience with integrated model. Material and methods. Ninety-six patients with paroxysmal atrial fibrillation (AF) after radiofrequency pulmonary vein isolation have been analyzed. In 48 patients, 3D mapping system integrated with fluoroscopy (Carto 3 UniVu) has been used. Clinical and peri-procedural data, inclusive, fluoroscopy time and dose, in-hospital complications and efficacy rate at 6 months have been compared. Results. Patients treated with classic 3D mapping system were significantly older (p = 0.036). Both fluoroscopy mean time (11.6 ± 4.3 vs. 6.7 ± 2.9 minutes, p < 0.05) and a median of the fluoroscopy dose [460.0 (IQR: 288.0–785.5) vs. 271.0 (IQR 145.0–535.0) mGy, p < 0.05] have been significantly reduced by using Carto3 UniVu. Total procedure time was comparable between groups. Periprocedural complications and recurrence of clinical arrhythmia rate in 6-month follow-up were comparable. Conclusions. Utilization of novel 3D mapping systems with classic fluoroscopy integration supports the radiation time and the dose reduction during AF ablation procedure, without any adverse impact on the total procedure time, complication or success rate. This real-life population results corresponds with previously presented prospective studies.