Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-198 - Meta-analysis Of Minimal Fluoroscopy Versus Conventional Fluoroscopy Approaches For Pulmonary Vein Isolation Ablation For Atrial Fibrillation (ID 1054)


Background: Atrial fibrillation (AF) ablation procedures are historically associated with higher fluoroscopy usage than other electrophysiology procedures. Recent efforts have been made to reduce patient and operator ionizing radiation exposure during pulmonary vein isolation (PVI) ablation procedures using alternative techniques.
Objective: We sought to undertake a meta-analysis of studies comparing zero or low fluoroscopy (LF) vs. conventional fluoroscopy (CF) approaches for AF ablation.
Methods: Articles were identified by a search of MEDLINE, EMBASE, and Cochrane databases before October 2019. Data were extracted independently and analyzed in aggregate with random effects models, using a Bayesian hierarchical approach.
Results: A total of 2228 participants (LF, n=1190 vs. CF, n=1038) from fifteen studies were included in the meta-analysis. Risk AF recurrence in 12 months (Odds ratio, OR 95% confidence interval [95% CI]=1.343 [0.771 to 2.340], P=0.297), redo-ablation procedures (OR [95% CI]=0.521 [0.198 to 1.323], P=0.186), and procedural complications (OR [95% CI]=0.99 [0.485 to 2.204], P=0.979) were similar between LF and CF ablation groups. In comparison to CF ablation, LF ablation led to shorter procedure duration (weighted mean differences WMD [95% CI]=-14.6 min [-22.5 to -6.8], P<0.001), fluoroscopy time (WMD [95% CI] =-8.8 min [-11.9 to -5.9], P<0.001), and dose area product (WMD [95% CI]=-1946 mGy/cm2 [-2685 to 1207], P<0.001).
Conclusion: LF approaches have similar clinical efficacy and safety as CF approaches for PVI. LF approaches though are associated with shorter procedure time, fluoroscopy usage, and dose area product during PVI.