| Title: |
Safety and Efficacy of TEE Guidance in Electrophysiological Procedures Without Fluoroscopy |
| Authors: |
Lyuboslav Katov; Theresa Kistner; Yannick Teumer; Federica Diofano; Carlo Bothner; Wolfgang Rottbauer; Karolina Weinmann-Emhardt |
| Source: |
Journal of Clinical Medicine ; Volume 14 ; Issue 6 ; Pages: 1917 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2025 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
zero fluoroscopy; near-zero fluoroscopy; left atrial electrophysiological procedures; 3D mapping; EAM; transesophageal echocardiography; radiation exposure |
| Description: |
Background/Objectives: Fluoroscopy has traditionally supported three-dimensional (3D) electroanatomical mapping (EAM)-guided left atrial (LA) electrophysiological procedures (EPs), but the associated ionizing radiation poses long-term health risks for patients and healthcare professionals. Advances in 3D EAM systems now enable nearly or entirely radiation-free ablations. Imaging techniques such as transesophageal echocardiography (TEE) are increasingly used for precise and safe LA access. This study evaluates the safety and efficacy of TEE-guided, zero-fluoroscopy/near-zero-fluoroscopy LA EPs in routine clinical practice. Methods: 142 consecutive patients undergoing LA EAM-guided radiofrequency ablation at the Ulm University Heart Center between October 2023 and November 2024 were analyzed. In total, 73 patients underwent zero-fluoroscopy/near-zero-fluoroscopy ablation guided solely by TEE, while another 69 patients received fluoroscopy-guided ablation using TEE and fluoroscopy guidance. Results: Of the 142 patients, 58.0 (40.8%) were female, and the median age was 73.0 (64.0; 79.0) years. A total of 53 (37.3%) underwent zero-fluoroscopy EP, 20 (14.1%) underwent near-zero-fluoroscopy EP, and 69 (48.6%) underwent fluoroscopy-guided EP. Procedure duration was without significantly relevant difference between both groups (132.0 vs. 133.0 min; p = 0.52). Median radiation exposure in the zero-fluoroscopy/near-zero-fluoroscopy group was 0 (0.0; 0.0) minutes, compared to significantly higher values in the fluoroscopy group (9.7 (5.9; 15.3) minutes; p < 0.001). No significant differences in complications were observed (p = 0.09). Conclusions: TEE-guided, radiation-free LA EP offers a safe and effective approach, significantly reducing radiation exposure and its associated risks while maintaining high procedural efficacy without increasing the risk of complications. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://dx.doi.org/10.3390/jcm14061917 |
| DOI: |
10.3390/jcm14061917 |
| Availability: |
https://doi.org/10.3390/jcm14061917 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.FC528592 |
| Database: |
BASE |