Near zerO fluoroscopic exPosure during catheter ablAtion of supRavenTricular arrhYthmias: The NO-PARTY multicentre randomized trial

Gemma Pelargonio, Michela Casella, Antonio Dello Russo, Silvia Riva, Maria Lucia Narducci, Gianluigi Bencardino, Francesco Perna, Maurizio Del Greco, Gianluca Zingarini, Marcello Piacenti, Andrea Di Cori, Victor Casula, Massimiliano Marini, Francesca Pizzamiglio, Martina Zucchetti, Stefania Riva, Ezio Soldati, Luca Panchetti, Umberto Startari, Luigi Di BiaseGiovanni Fattore, Mariagrazia Bongiorni, Eugenio Picano, Andrea Natale

Risultato della ricerca: Contributo in rivistaArticolo in rivista

56 Citazioni (Scopus)

Abstract

Aims Aim of this study was to compare a minimally fluoroscopic radiofrequency catheter ablation with conventional fluoroscopy-guided ablation for supraventricular tachycardias (SVTs) in terms of ionizing radiation exposure for patient and operator and to estimate patients' lifetime attributable risks associated with such exposure. Methods and results We performed a prospective, multicentre, randomized controlled trial in six electrophysiology (EP) laboratories in Italy. A total of 262 patients undergoing EP studies for SVT were randomized to perform a minimally fluoroscopic approach (MFA) procedure with the EnSiteTMNavXTM navigation system or a conventional approach (ConvA) procedure. The MFA was associated with a significant reduction in patients' radiation dose (0 mSv, iqr 0-0.08 vs. 8.87 mSv, iqr 3.67-22.01; P < 0.00001), total fluoroscopy time (0 s, iqr 0-12 vs. 859 s, iqr 545-1346; P < 0.00001), and operator radiation dose (1.55 vs. 25.33 μS per procedure; P < 0.001). In the MFA group, X-ray was not used at all in 72% (96/134) of cases. The acute success and complication rates were not different between the two groups (P = ns). The reduction in patients' exposure shows a 96% reduction in the estimated risks of cancer incidence and mortality and an important reduction in estimated years of life lost and years of life affected. Based on economic considerations, the benefits of MFA for patients and professionals are likely to justify its additional costs. Conclusion This is the first multicentre randomized trial showing that a MFA in the ablation of SVTs dramatically reduces patients' exposure, risks of cancer incidence and mortality, and years of life affected and lost, keeping safety and efficacy. Trial registration clinicaltrials.gov Identifier: NCT01132274.
Lingua originaleEnglish
pagine (da-a)1565-1572
Numero di pagine8
RivistaEuropace
Volume18
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Adult
  • Body Surface Potential Mapping
  • Catheter Ablation
  • Electroanatomical mapping
  • Female
  • Fluoroscopy
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Prospective Studies
  • Radiation Exposure
  • Radiation exposure
  • Radiofrequency ablation
  • Supraventricular tachycardia
  • Tachycardia, Supraventricular
  • Treatment Outcome

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