Friday, July 12, 2013

Role of MediGuideTM Technology in Atrial Fibrillation Ablation

Citation : Philipp Sommer, Sascha Rolf, Gerhard Hindricks

Background: Recently, a new technological platform has been introduced allowing almost non-fluoroscopic ablations in right atrial ablations like typical atrial flutter. We describe our first experience with the MediGuide®-technology in AF ablations. This technology platform allows non-fluoroscopic catheter visualization on prerecorded cine-loops and can contribute to significant reduction in radiation exposure. 

Methods: All patients ablated for AF in our institution with MediGuide™-Technology are enrolled in a registry. All procedural data, namely fluoroscopy time and dose, procedure time and acute success were analysed. We report on our initial 100 AF patients since the MediGuide enabled ablation catheters became available (May 2012).

Results: Some changes in the procedure workflow were made to optimally adapt to the opportunities of the MediGuide system. The overall procedure time was not prolonged as compared to conventional ablation procedures. Both the radiation dose and the fluoroscopy time were dramatically reduced as compared to standard ablations (4.3 ± 2.5min vs. 29 ± 5min; p<0.001), the radiation dose was 2412 ± 380 cGy cm² and the procedure time was 171 ± 32min. No adverse events associated with the use of the system were seen.

Conclusions: The MediGuide™ Technology allows safe AF ablation procedures with a significant reduction in fluoroscopy time and dosage. In daily practice, fluoroscopy times of 3min and less and dosages of <1000cGy/cm² are common. Procedure times for AF ablation procedures were not prolonged by the application of this new non-fluoroscopic catheter tracking technology and complication rate was not increased compared to conventional procedures.

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