Chinese expert consensus on the construction of the fluoroless cardiac electrophysiology laboratory and related techniques

Pacing Clin Electrophysiol. 2023 Sep;46(9):1035-1048. doi: 10.1111/pace.14782. Epub 2023 Aug 12.

Abstract

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X-rays. X-rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three-dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X-rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab.

Keywords: arrhythmia; catheter ablation; fluoroless catheter ablation; fluoroless electrophysiology catheterization laboratory; intracardiac echocardiography; three-dimensional mapping.

MeSH terms

  • Cardiac Electrophysiology
  • Catheter Ablation* / methods
  • Electrophysiologic Techniques, Cardiac* / methods
  • Humans
  • Surgery, Computer-Assisted* / methods
  • Treatment Outcome