Radiofrequency ablation can now be done without radiation! Recently, the electrophysiology team of the Department of Internal Medicine of Shenzhen Sun Yat-Sen Cardiovascular Hospital successfully performed radiofrequency ablation without radiation for eight patients with cardiac arrhythmias. The entire procedure was guided by a three-dimensional calibration system, eliminating the need for X-ray fluoroscopy and maximizing the protection of patients’ and healthcare workers’ health, which is the leading procedure in Shenzhen and even in China. In the cardiac catheterization room of Shenzhen Sun Yat-Sen Cardiovascular Hospital, several electrophysiologists have been “lightly loaded”, which was previously unthinkable. Previously, to do conventional radiofrequency ablation, doctors and nurses had to be fully armed, wearing lead protective clothing weighing 20 pounds, lead bibs, lead caps and lead glasses, while the patient was completely exposed to X-ray radiation. Although the medical personnel have taken strict protective measures, working under the rays for a long time and the accumulation of rays in the body over time can cause serious damage, and there are reports of significantly higher cancer rates among medical personnel exposed to X-rays at home and abroad. The heavy lead suit is also physically devastating to the operator, and many physicians suffer from chronic strain disorders such as herniated discs, while cumulative damage to the blood system from radiation is more common, and leukopenia is common for physicians who perform radiofrequency ablation. Radiofrequency ablation for the treatment of severe arrhythmias has the advantages of high success rate, few complications and low recurrence rate. However, during the procedure, in order to ensure that the catheter reaches the heart smoothly and stays accurately near the effective ablation target, conventional RF ablation must be guided under X-ray fluoroscopy, which helps the physician to see the whole process of catheter running in the body, which is necessary to ensure that RF ablation is performed safely, but this will naturally cause radiation damage to the patient and the health care personnel participating in the procedure. Although radiation doses in routine situations do not cause serious damage, there is a potential risk for special populations, such as adolescents in their developmental stages, women of childbearing age, and patients with low blood cells (especially white blood cells). How can we avoid X-rays and still see the trajectory of the catheter through the body? The 3D Positioning and Navigation System helps us solve this challenge. The system is similar to a GPS positioning system in that a reference electrode is attached to the patient’s body surface and a magnetic or electric field is used as a positioning reference. When the catheter moves inside the body and its magnetic or electric field changes, the positioning system is able to respond quickly, similar to how a GPS can accurately locate a vehicle when it is moving on a road. Using the intracavity or body surface electrodes as the position reference, it senses and locates the position of any electrode within the electric field as well as the position of the tip of the ablation catheter, the degree of bending and the direction of movement, and displays it after processing by a computer workstation, with a positioning accuracy of up to 0.6 mm. After the procedure begins with local anesthesia, the physician, guided by a 3D navigator, delivers three electrode catheters for diagnostic purposes based on a real-time trajectory map generated by the movement of electrodes within the cardiovascular cavity, and after routine electrophysiological examination, delivers the RF catheter into the cardiac cavity. With the aid of computer software, the physician observes the spatial location of each catheter within the cardiac cavity from any angle, adjusts the RF catheter, and marks the target site (lesion). Subsequently, the RF catheter releases energy, hits the target site, and announces that the RF ablation is successful. A RF ablation procedure for supraventricular tachycardia takes only 30 minutes, and the physician does not step on a fluoroscope during the entire procedure, the X-ray machine is idle, and the intended goal of zero radiation is achieved. The “three-dimensional navigation and positioning” radiofrequency ablation is a major “modification” based on the traditional ablation procedure, which achieves the treatment purpose and avoids radiation damage. Dr. Li Yifu, chief physician of Shenzhen Sun Yat-Sen Cardiovascular Hospital, said: The main advantages of this new technology are: 1) freedom from X-ray radiation, under the guidance of this calibration system, the whole procedure does not need X-ray guidance; 2) three-dimensional function, this calibration system can accurately establish a three-dimensional heart model with the help of ordinary catheters, and can clearly display the special parts of the heart, making ablation more simple and easy; 3) memory function, this system can clearly establish a three-dimensional heart model with the help of ordinary catheters. Memory function, this system can clearly show any position of the heart where the catheter has been, so as to avoid repeated site ablation of the catheter; 4, high safety, the whole ablation process can monitor the position of the catheter through the three-dimensional system, so as to avoid complications caused by the displacement of the ablation catheter. The electrophysiology team of the Department of Internal Five of Shenzhen Sun Yat-Sen Cardiovascular Hospital is the first to carry out non-fluoro-guided radiofrequency ablation under the 3D scaler system in Shenzhen, including ablation of atrioventricular node double pathway, atrioventricular bypass, atrial tachycardia, atrial flutter, and premature ventricular beats, etc. No complications occur, and 95% of patients have zero exposure for the procedure, and the rest have very low dose exposure. Compared with traditional RF ablation performed under X-ray fluoroscopy, it greatly reduces the amount of X-ray exposure and avoids complications such as radiation dermatitis and leukopenia, which is especially important for elderly and frail patients, young and pregnant women. The surgeon is also freed from the heavy lead suit and can focus more on the surgery. The development of this technology will benefit more patients and also eliminate the damage caused by radiation to medical staff, greatly reducing the labor intensity of doctors and helping medical staff to better serve patients. So to speak, zero-radiation RF ablation brings green hope to patients and medical staff!