ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2018
Implementation of a near-zero fluoroscopy approach in interventional electrophysiology: impact of operator experience.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- The use of minimal fluoroscopy for cardiac electrophysiology procedures: A meta-analysis and review of the literature.Clinical cardiology · 2021Pooled it
- Minimising radiation exposure in catheter ablation of ventricular arrhythmias.BMC cardiovascular disorders · 2021Article
- How to Achieve Near Zero Fluoroscopy During Radiofrequency Ablation of Atrial Fibrillation: A Strategy Used at Two Centers.Current cardiology reviews · 2021Article
- 2019 APHRS expert consensus statement on three-dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS.Journal of arrhythmia · 2020Review
- State of Fluoroless Procedures in Cardiac Electrophysiology Practice.The Journal of innovations in cardiac rhythm management · 2020Review
- [Radiation reduction in interventional electrophysiology : Results from operators with different levels of experience].Herzschrittmachertherapie & Elektrophysiologie · 2018Article
- Efficacy and safety of radial probe endobronchial ultrasound-transbronchial lung biopsy in peripheral pulmonary lesions without guide sheath and fluoroscopy.Therapeutic advances in respiratory diseaseArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCatheter ablation is performed under fluoroscopic guidance. Reduction of radiation dose for patients and staff is emphasized by current recommendations. Previous studies have shown that lower operator experience leads to increased radiation dose. On the other hand, less experienced operators may depend even more on fluoroscopic guidance. Our study aimed to evaluate feasibility and efficacy of a non-fluoroscopic approach in different training levels.
methodsFrom January 2017, a near-zero fluoroscopy approach was established in two centers. Four operators (beginner, 1st year fellow, 2nd year fellow, expert) were instructed to perform the complete procedure with the use of a 3-D mapping system without fluoroscopy. A historical cohort that underwent procedures with fluoroscopy use served as control group. Dose area product (DPA), procedure duration, acute procedural success, and complications were compared between the groups and for each operator.
resultsProcedures were performed in 157 patients. The first 100 patients underwent procedures with fluoroscopic guidance, the following 57 procedures were performed with the near-zero fluoroscopy approach. The results show a significant reduction in DPA for all operators immediately after implementation of the near-zero fluoroscopy protocol (control 637 ± 611 μGy/m
conclusionOur results show a 90% reduction of DPA shortly after implementation of a near-zero fluoroscopy approach in interventional electrophysiology even in operators in training.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.