Background: Radiation exposure to patients, physicians and lab staff is high during atrial fibrillation ablation procedures. Robotic Magnetic Navigation (RMT) has reduced the amount of fluoroscopy during RF ablation procedures; however, there have been reports of zero fluoroscopy using manual catheter PVI ablation techniques. We are reporting the first experience with zero fluoroscopy PVI using Robotic Magnetic Navigation.
Objective: Report procedural techniques as well as safety and efficacy of zero fluoroscopy during atrial fibrillation ablation using RMT.
Methods: Procedural data from all consecutive RMT cases at our institution from January 2018 to February 2019 were analyzed to compare safety and efficacy of fluoroless atrial fibrillation ablation procedure. A step-by-step zero fluoroscopy protocol was initiated in our EP laboratory using intracardiac echo and the Stereotaxis® Magnetic Navigation System.
Results: Of the total of 203 patients, 110 underwent AF ablation with RMT using standard fluoroscopy technique and 98 using zero fluoroscopy RMT AF ablation. Average fluoroscopy and total clinical procedure times before implementation of fluoroless technique were 8.1±3.4 and 100.7±27.2 min and subsequently were zero and 94.2±31.3 min, respectively. Total clinical procedure time was not statistically affected by the use of Flouroless technique (P=0.13). In all cases of fluoroless AF ablation, acute PVI was achieved with no intra-procedural complications.
Conclusion: Zero Fluoroscopy using Remote Magnetic Navigation is safe and provides excellent acute safety results. Procedure times were not significantly affected by adoption of fluoroless technique.