ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1582753
Acute and long-term procedural outcomes, arrhythmia recurrence and mortality after supraventricular arrhythmia ablation: a comparative study of fluoroscopy and zero-fluoroscopy guided techniques
Provisionally accepted
Kamilla Luca Dávid1*
Balázs Polgár1Péter Bógyi1
Zsolt Bári2
Istvan Marczell1Manuella Bogdan1
Zalan Gulyas1Mirjam Franciska Turáni1Judit Papp1Előd János Zsigmond1Emese Tóth-Zsámboki1
Gabor Duray1- 1Department of Cardiology, Central Hospital of Northern Pest, Budapest, Hungary
- 2György Gottsegen Hungarian Institute of Cardiology, Budapest, Hungary
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Zero-fluoroscopy (ZF) catheter ablation eliminates radiation exposure via use of 3-dimensional electroanatomical mapping. We aimed to assess safety and efficacy of ZF catheter ablation in the treatment of supraventricular tachycardias (SVTs), examine learning-curve characteristics and to evaluate long-term results and mortality.We analysed clinical characteristics, procedural and follow-up data of 605 consecutive patients undergoing catheter ablation for SVT (atrioventricular nodal re-entry tachycardia, n=297; atrial flutter, n=241 and accessory pathway mediated tachycardia, n=67) between June 2017 and September 2021. Procedures were either guided by conventional fluoroscopy (F, n=223) or by EnSite Precision mapping system (ZF, n=382) based on decision of the operating physician.Acute procedural success rate exceeded 98% across all arrhythmia groups for both ZF and F techniques (ZF: 99%, F: 100%, p=NS). 63% of patients underwent ZF procedures.Complication rate was low (0.66%), occurring only in the F group. Conversion rate to fluoroscopy was 7.8%. ZF procedures took an average of 5.1 minutes longer (ZF: 64.5±24.3 min vs. F: 59.4±29 min, p<0.05), however ZF procedure times were reduced over time. At 3.2 years, total mortality was 7% with no significant difference between ZF and F. Deaths were not related to the procedures. Atrial flutter showed significantly higher recurrence in ZF compared to F (83% vs. 94%, p<0.005).Catheter ablation of SVTs using zero-fluoroscopy approach have similar acute success, complication and mortality rate as conventional fluoroscopic interventions. However, we detected significantly higher long-term arrhythmia recurrence after ZF ablation of atrial flutter, meriting further investigation.
Keywords: zero-fluoroscopy catheter ablation, supraventricular tachycardia, Threedimensional electroanatomic mapping system, Learning-curve, Long-term mortality, Recurrence
Received: 24 Feb 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Dávid, Polgár, Bógyi, Bári, Marczell, Bogdan, Gulyas, Turáni, Papp, Zsigmond, Tóth-Zsámboki and Duray. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kamilla Luca Dávid, Department of Cardiology, Central Hospital of Northern Pest, Budapest, Hungary
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