• Ignacio Gil-Ortega, Alfredo Serna-Berná, Antonio Javier Trujillo-Santos, David Ramos-Amores, Beatriz Garrido-Corro, Ricio José Cortez-Salazar, Tamara Gabriela Archondo-Arce, and Juan Antonio Castillo-Moreno.
• Arrhythmia Unit, Cardiology Service, Hospital Universitario Santa Lucía, Calle Mezquita s, /n 30202, Cartagena, Murcia, Spain. ignaciogilortega@gmail.com.
• Ir J Med Sci. 2021 Feb 1; 190 (1): 79-87.

BackgroundElectroanatomical mapping systems (EMS) reduce fluoroscopy dose for the ablation. Higher costs and longer procedure times are the drawbacks associated with EMS. Our objective was to validate the efficiency of the EMS.ObjectiveTo demonstrate that using EMS is more efficient and as secure as the traditional system of ablation.MethodsFrom April 2013 to June 2018, all patients were included into two groups, according to the intention of ablation with or without fluoroscopy. Right, left, supraventricular and ventricular ablation were included. We compared procedure variables (fluoroscopy, radiofrequency and procedure times, ablation results, complication rates and costs of the procedure) that included material and detrimental effect of fluoroscopy.ResultsA total of 105 were included in the fluoroscopy group and 287 in the without fluoroscopy group. We found an important reduction in time and radiation dose in all the ablation procedures studied, without increasing the procedure time. No differences in ablation results nor complications rate were found. We found lower costs in the flutter ablation without fluoroscopy, similar costs in the right focal tachycardia ablation group and higher costs in the without fluoroscopy group for the AVNRT and left accessory pathway. When detrimental effect of fluoroscopy was added, all procedures without fluoroscopy were significantly more efficient than the ones performed with it.ConclusionsAblation without fluoroscopy is a technique as safe and effective as the conventional technique. Our study suggests that the radiation dose delivered to the patient and staff might be reduced, without increasing the total procedure time, being even more efficient.

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