Casella M, Dello Russo A, Fassini G, Andreini D, De Iuliis P, Mushtaq S, Bartoletti S, Riva S, Tondo C. Manifold benefits of choosing a minimally fluoroscopic catheter ablation approach. World J Cardiol 2013; 5(2): 8-11 [PMID: 23538845 DOI: 10.4330/wjc.v5.i2.8]
Corresponding Author of This Article
Michela Casella, MD, PhD, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy. michela.casella@ccfm.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Feb 26, 2013; 5(2): 8-11 Published online Feb 26, 2013. doi: 10.4330/wjc.v5.i2.8
Manifold benefits of choosing a minimally fluoroscopic catheter ablation approach
Michela Casella, Antonio Dello Russo, Gaetano Fassini, Daniele Andreini, Pasquale De Iuliis, Saima Mushtaq, Stefano Bartoletti, Stefania Riva, Claudio Tondo
Michela Casella, Antonio Dello Russo, Gaetano Fassini, Stefano Bartoletti, Stefania Riva, Claudio Tondo, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
Pasquale De Iuliis, St Jude Medical Italy, 20138 Milan, Italy
Author contributions: Casella M and Dello Russo A contributed to conception and design, acquisition of data, analysis and interpretation of data; drafting the article; final approval of the version to be published; Fassini G, Andreini D, De Iuliis P, Mushtaq S and Riva S contributed to conception and design, acquisition of data, analysis and interpretation of data; Bartoletti S drafted the article; Tondo C contributed to the final approval of the version to be published.
Correspondence to: Michela Casella, MD, PhD, Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy. michela.casella@ccfm.it
Telephone: +39-2-58002340 Fax: +39-2-58002398
Received: September 5, 2012 Revised: December 11, 2012 Accepted: December 21, 2012 Published online: February 26, 2013
Abstract
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 NavX™ 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.
