000168331 001__ 168331
000168331 005__ 20260204153543.0
000168331 0247_ $$2doi$$a10.1007/s10840-021-01086-9
000168331 0248_ $$2sideral$$a146843
000168331 037__ $$aART-2021-146843
000168331 041__ $$aeng
000168331 100__ $$aFalasconi, G
000168331 245__ $$aA standardized stepwise zero-fluoroscopy approach with transesophageal echocardiography guidance for atrial fibrillation ablation.
000168331 260__ $$c2021
000168331 5060_ $$aAccess copy available to the general public$$fUnrestricted
000168331 5203_ $$aPurpose
There is growing interest in performing fluoroless radiofrequency ablation (RFA) for atrial fibrillation (AF) due to the increasing awareness of risk associated with radiation exposure of patients and professional staff. The present study aimed to evaluate the feasibility, safety, and efficacy of a stepwise transesophageal echocardiography (TEE)–guided zero-fluoroscopy approach (ZFA) for RFA.
Methods
Consecutive patients (n = 111) referred for AF-ablation were prospectively enrolled with intention to RFA with ZFA. Procedural outcomes were compared with historical controls (HCs) after 1:1 propensity score matching. ZFA success was considered when no X-ray was utilized to perform the whole procedure.
Results
ZFA success was achieved in 80 (72%) procedures. BMI > 35 kg/m2 resulted in the only independent predictor of ZFA failure (OR = 6.10, 95% CI 1.15–46.49, p = 0.04). In comparison to HCs, a significant reduction in radiation exposure was observed in the ZFA group: fluoroscopy time (3 vs. 63 s, p < 0.001), total emitted fluoroscopy dose (0.2 vs. 6.0 mGy, p < 0.001), dose area product (0.04 vs. 1.4 Gy*cm2, p < 0.001), and effective dose (0.8 vs. 27.2 mSv*100, p < 0.001). Complete pulmonary vein isolation was achieved in all procedures. No difference was observed between the groups in in-hospital complication rate (0.9% vs. 1.8%, p = 0.99).
Conclusions
This is the largest study proving procedural feasibility, safety, and efficacy of TEE-guided AF-ablation with a complete or near-complete avoidance of radiological exposure, without using intracardiac echocardiography.
000168331 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000168331 590__ $$a1.759$$b2021
000168331 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b122 / 143 = 0.853$$c2021$$dQ4$$eT3
000168331 592__ $$a0.68$$b2021
000168331 593__ $$aMedicine (miscellaneous)$$c2021$$dQ2
000168331 593__ $$aCardiology and Cardiovascular Medicine$$c2021$$dQ2
000168331 594__ $$a3.0$$b2021
000168331 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000168331 700__ $$aPenela, D
000168331 700__ $$aSoto-Iglesias, D
000168331 700__ $$0(orcid)0000-0001-9187-1773$$aJáuregui, B
000168331 700__ $$aChauca, A
000168331 700__ $$aAntonio, RS
000168331 700__ $$aOrdoñez, A
000168331 700__ $$aTeres, C
000168331 700__ $$aCarreño, JM
000168331 700__ $$aScherer, C
000168331 700__ $$aViveros, D
000168331 700__ $$aHuguet, M
000168331 700__ $$aTorres, J
000168331 700__ $$aVergara, P
000168331 700__ $$aMaldonado, G
000168331 700__ $$aPanaro, A
000168331 700__ $$aCámara, O
000168331 700__ $$aBerruezo, A
000168331 773__ $$g64 (2021), 629 - 639$$pJ. Interv. Card. Electrophysiol.$$tJOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY$$x1383-875X
000168331 8564_ $$s3520708$$uhttps://zaguan.unizar.es/record/168331/files/texto_completo.pdf$$yPostprint
000168331 8564_ $$s1452115$$uhttps://zaguan.unizar.es/record/168331/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000168331 909CO $$ooai:zaguan.unizar.es:168331$$particulos$$pdriver
000168331 951__ $$a2026-02-04-13:13:55
000168331 980__ $$aARTICLE