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

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 with conventional radiofrequency ablation method, zero or near-zero fluoroscopy ablation significantly showed reduced fluoroscopic time (standard mean difference [SMD] −1.62, 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.