Manifold benefits of choosing a minimally fluoroscopic catheter ablation approach  

作　　者：Michela Casella Antonio Dello Russo Gaetano Fassini Daniele Andreini Pasquale De Iuliis Saima Mushtaq Stefano Bartoletti Stefania Riva Claudio Tondo 

机构地区：[1]Cardiac Arrhythmia Research Centre,Centro Cardiologico Monzino IRCCS [2]Cardiovascular Imaging Department,Centro Cardiologico Monzino IRCCS [3]St Jude Medical Italy

出　　处：《World Journal of Cardiology》2013年第2期8-11,共4页世界心脏病学杂志（英文版）（电子版）

摘　　要：We report the case of a 14-year-old boy with ventricular preexcitation. A standard, fluoroscopy guided, ablation procedure was successfully performed in a postero-midseptal region with a total fluoroscopy time of about 45 min (2430 cGy.cm2). A few hours after the procedure, preexcitation reappeared. A second ablation procedure was scheduled using the EnSite NavXTM mapping system. During mapping along the tricuspid groove, preexcitation suddenly disappeared due to mechanical "bumping" of the accessory pathway and it did not recover over the next 30 min. As per our routine practice, the phase of geometry reconstruction has been continuously recorded by the system; thus, an off-line analysis allowed to pinpoint the site of earliest activation and the site of mechanical bumping, where radiofrequency obtained the accessory pathway ablation. The second procedure was performed without using fluoroscopy at all. Thanks to the geometry reconstruction, the procedure was completely successful thus avoiding a further rehospitalization.We report the case of a 14-year-old boy with ventricular preexcitation. A standard, fluoroscopy guided, ablation procedure was successfully performed in a postero-midseptal region with a total fluoroscopy time of about 45 min (2430 cGy.cm2). A few hours after the procedure, preexcitation reappeared. A second ablation procedure was scheduled using the EnSite NavXTM mapping system. During mapping along the tricuspid groove, preexcitation suddenly disappeared due to mechanical "bumping" of the accessory pathway and it did not recover over the next 30 min. As per our routine practice, the phase of geometry reconstruction has been continuously recorded by the system; thus, an off-line analysis allowed to pinpoint the site of earliest activation and the site of mechanical bumping, where radiofrequency obtained the accessory pathway ablation. The second procedure was performed without using fluoroscopy at all. Thanks to the geometry reconstruction, the procedure was completely successful thus avoiding a further rehospitalization.

关 键 词：SUPRAVENTRICULAR ARRHYTHMIAS ACCESSORY PATHWAY RADIOFREQUENCY ablation Electroanatomical mapping Radiation exposure 

分 类 号：R725.4[医药卫生—儿科]