ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2021
Operator learning curve and clinical outcomes of zero fluoroscopy catheter ablation of atrial fibrillation, supraventricular tachycardia, and ventricular arrhythmias.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses 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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Zero and Minimal Fluoroscopic Approaches During Ablation of Supraventricular Tachycardias: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- The use of minimal fluoroscopy for cardiac electrophysiology procedures: A meta-analysis and review of the literature.Clinical cardiology · 2021Pooled it
- Sub-Zero: A Review of the Current Evidence and Evolving Technologies Enabling Zero‑Fluoroscopy Procedures.Pacing and clinical electrophysiology : PACE · 2026Review
- Zero Fluoroscopy Catheter Ablation of Accessory Pathways and AV Nodal Re-Entry Tachycardia: A Single Institution Study.Pacing and clinical electrophysiology : PACE · 2026Review
- Multicenter Practice of Non/Minimized Fluoroscopy Ablation for Paroxysmal AF in China: The PAF-ICE Trial.JACC. Asia · 2025Article
- Zero-fluoroscopy approach for radiofrequency catheter ablation of left-sided, idiopathic ventricular arrhythmias - feasibility, efficacy, and safety evaluation.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2024Article
- Intracardiac Echocardiography: An Invaluable Tool in Electrophysiological Interventions for Atrial Fibrillation and Supraventricular Tachycardia.Reviews in cardiovascular medicine · 2024Review
- The Fluoroless Future in Electrophysiology: A State-of-the-Art Review.Diagnostics (Basel, Switzerland) · 2024Review
- Zero-fluoro atrioventricular-nodal reentrant tachycardia ablation.Herzschrittmachertherapie & Elektrophysiologie · 2023Article
- Fluoroless catheter ablation of atrial fibrillation: a step-by-step workflow.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
- Use of a mixed reality system for navigational mapping during cardiac electrophysiological testing does not prolong case duration: A subanalysis from the Cardiac Augmented REality study.Cardiovascular digital health journal · 2023Article
- Zero fluoroscopy catheter ablation for atrial fibrillation: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2023Review
- Aegrescit medendo: orthopedic disability in electrophysiology - call for fluoroscopy elimination-review and commentary.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Fluoroless Catheter Ablation of Atrial Fibrillation: Integration of Intracardiac Echocardiography and Cartosound Module.Journal of atrial fibrillation · 2021Article
- Effect of fluoroscopy frame rate on radiation exposure and in-hospital outcomes in three-dimensional electroanatomic mapping guided procedures.Journal of arrhythmia · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo investigate the learning curve for atrial fibrillation (AF), supraventricular tachycardia (SVT), and premature ventricular contraction (PVC) radiofrequency ablation (RFA) using zero fluoroscopy.
methodsThis is a retrospective, single-center study of 167 patients undergoing ablation between 2016 and 2019. Minimal fluoroscopy approach was initiated after the first 20 cases of PVI and SVT RFA. Procedures were divided consecutively into increments of 10 cases to determine operator learning curve.
resultsA total of 64 (38%) had SVT ablations, 26 (16%) had PVC ablations, and 77 (46%) had AF and underwent PVI. For SVT RFA, fluoroscopy time improved from 4.1 ± 3.5 min during the first 10 cases to 0.8 ± 1.2 min after 50 cases (p = 0.0001). Sixty-two out of 64 (97%) of cases were successful. In PVC RFA, fluoroscopy time was 7.7 ± 5.5 min for the first 5, 2.3 ± 3.4 min after 15, and 0 min after 20 cases (p = 0.0008). Twenty-four out of 26 (92%) of cases were acutely successful with recurrence in 2/26 (8%) of patients over 9 ± 9 months. In PVI, fluoroscopy time was 9.9 ± 3.3 min over the first 20 cases, 2.6 ± 2.3 min after 40 cases, and 0.1 min after 50 cases (p < 0.0001). PVI procedure time was 170 ± 34 min after 60 cases from 235 ± 41 min initially (p 0.001). Six out of 77 (8%) had AF recurrence at 12 months.
conclusionsZero fluoroscopy ablation for AF, SVT, and PVC can be safely achieved without increasing procedure time. The steepest learning curve occurs over the first 20, 15, and 40 cases for SVT, PVC, and PVI ablation respectively.
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Registered trials
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