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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:699-705 - Vol. 70 Num.09 DOI: 10.1016/j.rec.2016.12.040

Nonfluoroscopic Catheter Ablation. Results From a Prospective Multicenter Registry

Miguel Álvarez a,, Vicente Bertomeu-González b, M. Fe Arcocha c, Pablo Moriña d, Luis Tercedor a, Ángel Ferrero de Loma e, Marta Pachón f, Amaya García g, Mónica Pardo h, Tomás Datino i, Concepción Alonso j, Joaquín Osca k

a Departamento de Cardiología, Complejo Hospitalario Universitario de Granada, Granada, Spain
b Departamento de Cardiología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain
c Departamento de Cardiología, Hospital de Basurto, Bilbao, Vizcaya, Spain
d Departamento de Cardiología, Hospital Juan Ramón Jiménez, Huelva, Spain
e Departamento de Cardiología, Hospital Clínico de Valencia, Valencia, Spain
f Departamento de Cardiología, Hospital Virgen de la Salud, Toledo, Spain
g Departamento de Cardiología, Hospital General de Alicante, Alicante, Spain
h Departamento de Cardiología, Hospital do Meixoeiro, Vigo, Pontevedra, Spain
i Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
j Departamento de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
k Departamento de Cardiología, Hospital La Fe, Valencia, Spain

Refers to


Registry. Catheter ablation. Fluoroscopy.


Introduction and objectives

Nonfluoroscopic catheter ablation is feasible in most procedures. The aim of our registry was to evaluate the safety and feasibility of a zero-fluoroscopic approach to catheter ablation in several Spanish centers.


Eleven centers prospectively included a minimum of 20 patients. Patients with an arrhythmic substrate deemed suitable by the operator for a zero-fluoroscopic approach throughout the procedure were recruited. Patients with intracardiac devices were not included. Attending electrophysiologists, fellows, and resident physicians participated in each procedure, as in usual care.


The study included 247 patients. Ablation was performed in 235 patients (95.2%). In 2 patients, who were not included in the analysis, fluoroscopy was performed as the first-line treatment. The arrhythmic substrate was located in the right chambers in most of the procedures (231 of 233 [99.15%]). Fluoroscopy was used in 24 procedures (10.3%). Catheter ablation was successful in 96.4% of the procedures and severe complications occurred in 2 patients (0.85%). Two variables were related to the need for fluoroscopy: the performing center (minimum 0% vs maximum 30.3%; P = .001) and procedural failure (13% vs 2.4%; P < .05).


The Spanish multicenter registry reveals that a zero-fluoroscopic approach is feasible in most right-sided catheter ablation procedures. Randomized trials are necessary to confirm the safety of this approach. The need for fluoroscopy was related to procedural failure, with significant differences among performing centers.

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved