Dataset Information

Extremely low-frame-rate digital fluoroscopy in catheter ablation of atrial fibrillation: A comparison of 2 versus 4 frame rate.

ABSTRACT: Despite the technological advance in 3-dimensional (3D) mapping, radiation exposure during catheter ablation of atrial fibrillation (AF) continues to be a major concern in both patients and physicians. Previous studies reported substantial radiation exposure (7369-8690?cGy cm) during AF catheter ablation with fluoroscopic settings of 7.5 frames per second (FPS) under 3D mapping system guidance. We evaluated the efficacy and safety of a low-frame-rate fluoroscopy protocol for catheter ablation for AF.Retrospective analysis of data on 133 patients who underwent AF catheter ablation with 3-D electro-anatomic mapping at our institute from January 2014 to May 2015 was performed. Since January 2014, fluoroscopy frame rate of 4-FPS was implemented at our institute, which was further decreased to 2-FPS in September 2014. We compared the radiation exposure quantified as dose area product (DAP) and effective dose (ED) between the 4-FPS (n?=?57) and 2-FPS (n?=?76) groups.The 4-FPS group showed higher median DAP (599.9?cGy cm; interquartile range [IR], 371.4-1337.5?cGy cm vs. 392.0?cGy cm; IR, 289.7-591.4?cGy cm; P?

SUBMITTER: Lee JH

PROVIDER: S-EPMC5478349 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Extremely low-frame-rate digital fluoroscopy in catheter ablation of atrial fibrillation: A comparison of 2 versus 4 frame rate.

Lee Ji Hyun JH Kim Jun J Kim Minsu M Hwang Jongmin J Hwang You Mi YM Kang Joon-Won JW Nam Gi-Byoung GB Choi Kee-Joon KJ Kim You-Ho YH

Medicine 20170601 24

Despite the technological advance in 3-dimensional (3D) mapping, radiation exposure during catheter ablation of atrial fibrillation (AF) continues to be a major concern in both patients and physicians. Previous studies reported substantial radiation exposure (7369-8690 cGy cm) during AF catheter ablation with fluoroscopic settings of 7.5 frames per second (FPS) under 3D mapping system guidance. We evaluated the efficacy and safety of a low-frame-rate fluoroscopy protocol for catheter ablation fo ...[more]

PMID: 28614264

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Project description:AF is a heterogeneous rhythm disorder that is related to a wide spectrum of etiologies and has broad clinical presentations. Mechanisms underlying AF are complex and remain incompletely understood despite extensive research. They associate interactions between triggers, substrate and modulators including ionic and anatomic remodeling, genetic predisposition and neuro-humoral contributors. The pulmonary veins play a key role in the pathogenesis of AF and their isolation is associated to high rates of AF freedom in patients with paroxysmal AF. However, ablation of persistent AF remains less effective, mainly limited by the difficulty to identify the sources sustaining AF. Many theories were advanced to explain the perpetuation of this form of AF, ranging from a single localized focal and reentrant source to diffuse bi-atrial multiple wavelets. Translating these mechanisms to the clinical practice remains challenging and limited by the spatio-temporal resolution of the mapping techniques. AF is driven by focal or reentrant activities that are initially clustered in a relatively limited atrial surface then disseminate everywhere in both atria. Evidence for structural remodeling, mainly represented by atrial fibrosis suggests that reentrant activities using anatomical substrate are the key mechanism sustaining AF. These reentries can be endocardial, epicardial, and intramural which makes them less accessible for mapping and for ablation. Subsequently, early interventions before irreversible remodeling are of major importance. Circumferential pulmonary vein isolation remains the cornerstone of the treatment of AF, regardless of the AF form and of the AF duration. No ablation strategy consistently demonstrated superiority to pulmonary vein isolation in preventing long term recurrences of atrial arrhythmias. Further research that allows accurate identification of the mechanisms underlying AF and efficient ablation should improve the results of PsAF ablation.

Dataset Information

Extremely low-frame-rate digital fluoroscopy in catheter ablation of atrial fibrillation: A comparison of 2 versus 4 frame rate.

Publications

Extremely low-frame-rate digital fluoroscopy in catheter ablation of atrial fibrillation: A comparison of 2 versus 4 frame rate.

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