Introduction Atrial fibrillation ablation
has historically been guided by fluoroscopy
, with the related enhanced risk deriving from radiation. Fluoroscopy
exposure may be confined to guide the transseptal puncture. Small sample size study presented a new methodology to perform a totally fluoroless atrial fibrillation ablation
in the case of a patent foramen ovale
(PFO). We evaluated this methodology in a large sample size of patients and a multicentre experience.
Methods and results
Two hundred and fifty paroxysmal atrial fibrillation
patients referred for first atrial fibrillation ablation
with a CARTO3 electroanatomic mapping system were enrolled. In 58 out of 250 patients, a PFO allowed crossing of the interatrial septum, and a completely fluoroless ablation
was performed applying the new method (Group A). In the remaining patients, a standard transseptal puncture was performed (Group B). Pulmonary vein isolation was achieved in all patients with comparable procedural and clinical outcomes at short- and long-term follow-up.
The presence of a PFO may allow a completely fluoroless well tolerated and effective atrial fibrillation ablation
. Probing the fossa ovalis looking for the PFO during the procedure is desirable, as it is not time-consuming and can potentially be done in every patient undergoing atrial fibrillation ablation