ablação de fa sem fluoroscopia (zero fluoro) · ad 1 pt 62 ±15 anos 60% masc *4 pts - mp ddd....
TRANSCRIPT
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Eduardo B. Saad MD, PhD, FHRS, FESC
Serviço de Arritmias e Estimulação Artificial
Centro de Fibrilação Atrial
Hospital Pró-Cardíaco - Rio de Janeiro - RJ
Ablação de FA sem Fluoroscopia
(Zero Fluoro)
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The Problem…
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Efeitos Estocásticos e Determinísticos
• Determinísticos
• Existe um limiar de dose
• Estocásticos
• Não existe um limiar de dose
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Dose em Intervencionismo
Dose no profissional
0,1 a 1,0 mSv
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Radioprotective Measures
ALARA
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Why do We Rely on Fluoroscopy?
Comfort in “believing where the catheter is”
Knowing where the catheter is going
Understanding (Trust) the mapping system
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Use alternative imaging sources
Techniques for Fluoro Reduction
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Zero Fluoro Procedure
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Métodos
70 pts
FA
51 pts
SVTs
19 pts
FA parox 33 pts
FA pers 18 pts
TRN 11 pts
WPW 5 pts
ICT 2 pts
Atriot. AD 1 pt
62 ± 15 anos
60% masc
*4 pts - MP DDD
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Directed Catheter Control
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ICEEYES
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Catheter Navigation to RA
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Catheter Navigation to RA
Echo-free Space Wire in Vein
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Catheter Navigation to RA
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SVC Positioning
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Catheter Navigation in RA
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CS Reconstruction and Cannulation
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Transeptal Access
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Transeptal
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Pentaray FAM
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Multipolar Mapping- Pentarray
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PVI - Contact Force
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LAA Ridge Ablation
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Complications - Thrombus Formation
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Complications - Pericardial Effusion
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Zero Fluoro - Extensive Ablation
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Conclusions
• Why? – because it’s dangerous!
• When? – Always!
• How? – Change your mind!
Rely on other methods!
• 3D Mapping + ICE
ALARA = Zero Fluoro
AF Ablation Without X-ray:
#iceeyes
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Video kindly given by
Guilherme SaadThank You!