Meta-Analysis of Zero or Near-Zero Fluoroscopy Use during Ablation of Cardiac Arrhythmias

Abstract Data regarding the efficacy and safety of zero or near-zero fluoroscopic ablation of cardiac arrhythmias are limited. A literature search was conducted using PubMed and Embase for relevant studies through January 2016. Ten studies involving 2,261 patients were identified. Compared to conventional radiofrequency ablation method, zero or near-zero fluoroscopy ablation significantly showed reduced fluoroscopic time (SMD = -1.62; 95% 95% CI: -2.20 to -1.05; P < 0.00001), ablation time (SMD = -0.16; 95% CI: -0.29 to -0.04; P = 0.01), and radiation dose (SMD = -1.94; 95% CI: -3.37 to -0.51; P = 0.008). In contrast, procedure duration was not significantly different from that of conventional radiofrequency ablation (SMD = -0.03; 95% CI: -0.16 to 0.09; P = 0.58). There were no significant differences between both groups in immediate success rate (odds ratio [OR] = 0.99; 95% CI: 0.49 to 2.01; P = 0.99), long-term success rate (OR = 1.13; 95% CI: 0.42 to 3.02; P = 0.81), complication rates (OR = 0.98; 95% CI: 0.49 to 1.96; P = 0.95), and recurrence rates (OR = 1.29; 95% CI: 0.74 to 2.24; P = 0.37). In conclusion, radiation was significantly reduced in the zero or near-zero fluoroscopy ablation groups without compromising efficacy and safety.