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Fluoroscopy and contrast media use in cryoballoon ablation of atrial fibrillation using a novel imaging system

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Abstract

Pulmonary vein (PV) isolation using cryoballoon (CB) catheter is generally characterized by a high radiation and contrast media exposure. A new dielectric imaging system (KODEX–EPD imaging system) allows pulmonary vein (PV) occlusion assessment without dye use. The purpose of this study was to verify the feasibility of reducing the radiation and dye use during CB ablation in patients with atrial fibrillation (AF) using the new dielectric imaging system. In a retrospective, single center study, we enrolled 34 consecutive patients with paroxysmal AF divided in two groups: 17 patients in Conventional Group underwent the procedure under fluoroscopy guidance before the new system introduction, while 17 patient in KODEX–EPD Group underwent the procedure under fluoroscopy and KODEX–EPD imaging system guidance. There were no differences in any clinical and anatomical characteristics between the two study groups. Overall procedure time was comparable between the two groups (69 [IQR 63–98] min in Conventional Group vs. 65 [IQR 58–74] min in KODEX–EPD Group, p = 0.16), while fluoroscopy time (8 [IQR 5–9] min vs. 11 [IQR 9–12] min, p = 0.014) and dye use (35 [IQR 28–45] ml vs. 70 [IQR 57–83] ml, p < 0.001) were significantly lower in the KODEX–EPD Group. No 30-day complications were observed. At 12-month follow-up 7/37 (19%) patients had an atrial arrhythmias recurrence, without any difference between the two study groups (17.6% vs. 23.5%, p = 0.68). The use of a new dielectric imaging system allowed a significantly reduction in radiation exposure and dye use during CB ablation in patients with AF.

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Authors and Affiliations

  1. Clinica Montevergine, Via Mario Malzoni 5, 83013, Mercogliano, AV, Italy

    Vincenzo Schillaci, Giuseppe Stabile, Alberto Arestia, Gergana Shopova, Alessia Agresta, Sara Poggi, Armando Salita, Carmine Romano & Francesco Solimene

  2. Casa di Cura San Michele, Maddaloni, CE, Italy

    Giuseppe Stabile & Antonio De Simone

  3. Anthea Hospital, Bari, Italy

    Giuseppe Stabile

  4. EPD Solution, Milan, Italy

    Carlo Maria Giannitti & Andrea Natalizia

Authors
  1. Vincenzo Schillaci
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  2. Giuseppe Stabile
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  3. Alberto Arestia
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  4. Gergana Shopova
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  5. Alessia Agresta
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  6. Sara Poggi
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  7. Armando Salita
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  8. Carmine Romano
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  9. Carlo Maria Giannitti
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  10. Andrea Natalizia
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  12. Francesco Solimene
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Contributions

Concept/design: VS, GS, and FS; data analysis/interpretation: VS, GS, AA, GS, AA, SP, AS, CR, CMG, AN, ADS, and FS; drafting and critical revision of the article: VS, GS, AA, GS, AA, SP, AS, CR, CMG, AN, ADS, and FS; final approval of the article: VS, GS, AA, GS, AA, SP, AS, CR, CMG, AN, ADS, and FS; statistics: VS, GS, and CMG; data collection: VS, GS, AA, GS, AA, SP, AS, CR, ADS, and FS.

Corresponding author

Correspondence to Giuseppe Stabile.

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Conflict of interest

Carlo Maria Giannitti, and Andrea Natalizia are employee of EPD Solution Italy, no other conflict of interest exists.

Ethical approval

Ethical approval was waived by institutional review committees in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

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Written informed consent was obtained from the parents.

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Schillaci, V., Stabile, G., Arestia, A. et al. Fluoroscopy and contrast media use in cryoballoon ablation of atrial fibrillation using a novel imaging system. Heart Vessels 37, 115–120 (2022). https://doi.org/10.1007/s00380-021-01902-2

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  • DOI: https://doi.org/10.1007/s00380-021-01902-2

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