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Title of Journal: J Interv Card Electrophysiol

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Abbravation: Journal of Interventional Cardiac Electrophysiology

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Springer US

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DOI

10.1007/bf01613765

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1572-8595

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Factors associated with fluoroscopy exposure durin

Authors: Grace Wan Kevin M Shannon Jeremy P Moore
Publish Date: 2012/08/02
Volume: 35, Issue: 2, Pages: 235-242
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Abstract

Exposure to ionizing radiation during electrophysiologic procedures in children is believed to increase the risk of future malignancy Electroanatomical navigation can reduce exposure but the cohort of children who derive the greatest benefit from this approach is incompletely defined We sought to determine factors associated with fluoroscopy exposure with conventional catheter ablation versus electroanatomical navigationA retrospective review of all ablation procedures over a 5year period during the transition to electroanatomical navigation performed by a single electrophysiologist was performed Fluoroscopy time 20 min was considered “prolonged” Statistical analysis was performed to determine differences among groupsTwo hundred thirtyfour subjects underwent catheter ablation during the study period conventional n = 127 navigation n = 107 Mean fluoroscopy decreased from 111 to 35 min with electroanatomical navigation p  00001 Overall 53/107 subjects 50  undergoing catheter ablation using electroanatomical navigation required no fluoroscopy of which atrioventricular nodal reentry tachycardia AVNRT n = 23 and rightsided accessory pathways n = 22 were most common p = 0001 Prolonged fluoroscopic exposure was observed for 22/127 17  subjects undergoing conventional fluoroscopy versus 3/107 3  subjects with electroanatomical navigation p = 0001 and was not observed after increased experience Flouroscopy time decreased significantly after the first 20 procedures p = 004 There was no difference in success complication or recurrence rate between groupsElectroanatomical navigation significantly reduced fluoroscopic exposure without compromising safety efficacy or recurrence Subjects with AVNRT and rightsided accessory pathways derived the greatest benefit as did those requiring prolonged fluoroscopy by the conventional approachThis study provides additional evidence on the importance of 3D mapping in clinical practice With the introduction of 3D mapping systems the investigators were able to reduce the fluoroscopy exposure during ablation procedures in pediatric patients


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Other Papers In This Journal:

  1. Adenosine triphosphate-induced atrial fibrillation: the clinical significance and relevance to spontaneous atrial fibrillation
  2. Trends in percutaneous pericardial access during catheter ablation of ventricular arrhythmias: a single-center experience
  3. Comparison between pulsed and continuous radiofrequency delivery
  4. Electrophysiologic characteristics of atrial tachycardia originating from the superior vena cava
  5. Clinical evaluation of a new technique to monitor return electrode skin temperature during radiofrequency ablation
  6. Arrhythmia phenotype in mouse models of human long QT
  7. Contact force and impedance decrease during ablation depends on catheter location and orientation: insights from pulmonary vein isolation using a contact force-sensing catheter
  8. Long-term monitoring of respiratory rate in patients with heart failure: the Multiparametric Heart Failure Evaluation in Implantable Cardioverter-Defibrillator Patients (MULTITUDE-HF) study
  9. Association between red blood cell distribution width and response to cardiac resynchronization therapy
  10. Modification of atrioventricular conduction in dogs by laser irradiation of Koch’s triangle guided by balloon-tipped cardioscope
  11. Novel SCN5A mutations in two families with “Brugada-like” ST elevation in the inferior leads and conduction disturbances
  12. Clinical criteria for predicting benefit of ICD/PM in post myocardial infarction patients: an AVID and CAST analysis
  13. Characteristics and distribution of complex fractionated atrial electrograms in patients with paroxysmal and persistent atrial fibrillation
  14. Predictors of serious arrhythmic events in patients with nonischemic heart failure
  15. Ablation time efficiency and lesion volume - in vitro comparison of 4 mm, non irrigated, gold- and platinum-iridium-tip radiofrequency ablation catheters
  16. Late thromboembolic events after circumferential pulmonary vein ablation of atrial fibrillation
  17. Fluoroless catheter ablation in adults: a single center experience
  18. Patient care and physician conflicts of interests: the Hydra grows new heads but is any Hercules in sight?
  19. Cardiac calcified amorphous tumor in a patient presenting for ventricular tachycardia ablation: intracardiac echocardiogram diagnosis and management
  20. Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome—the heart to gut connection!
  21. Clinical outcome of left atrial ablation for paroxysmal atrial fibrillation is related to the extent of radiofrequency ablation
  22. Predictors of chronic pulmonary vein reconnections after contact force-guided ablation: importance of completing electrical isolation with circumferential lines and creating sufficient ablation lesion densities
  23. Left atrial posterior wall isolation: the icing on the cake
  24. Catheter ablation of arrhythmic storm triggered by monomorphic ectopic beats in patients with coronary artery disease
  25. Verapamil-sensitive left anterior fascicular ventricular tachycardia associated with a healed myocardial infarction: changes in the delayed Purkinje potential during sinus rhythm

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