Atrial flutter ablation without use of fluoroscopy

Introduction: Radiofrequency ablation procedures are usually guided by fluoroscopy, however the use of X rays is potentially harmful for both the patient and the medical and paramedical staff. Objectives: To compare the results of radiofrequency ablation performed exclusively for the navigation systems, with those made with conventional techniques in patients with typical atrial flutter Methods: Five patients with typical atrial flutter were ablated only with the assistance of the navigation systems (group I), and compared retrospectively with 21 similar cases, made with the conventional technique (group II). The endpoint of the procedure was the confirmation of bidirectional block of the cavo-tricuspid isthmus and non-inducibility of atrial flutter. We analyzed the recurrence of clinical arrhythmia and holter until 6 months after the ablation procedure. Results: No significant differences between groups with respect to the success of the procedure: Gr I = 5p (100%) vs. Gr II = 20p (95.2%). In Gr I there were no complications, and Gr II a hematoma on the puncture site. The average fluoroscopy time in the Gr II was 15 +/- 8 min, not requiring the use of it in group I. The incidence of recurrence was similar in both groups (0% vs. 4.7% Gr I Gr II). Conclusions: In patients with typical atrial flutter, radiofrequency ablation exclusively with navigation systems is a feasible and safe technique, with results comparable to the conventional technique.