Radiofrequency ablation therapy has become the most effective means of curing cardiac arrhythmias, and has its own irreplaceable advantages for complex arrhythmias such as supraventricular tachycardia, atrial tachycardia, ventricular tachycardia and atrial flutter. However, today’s electrophysiological procedures cannot be performed without X-ray fluoroscopy, which is required to determine the exact position of the catheter or electrode to improve the success rate and reduce complications. Although there have been very few incidents where X-rays have had a serious impact on physicians and patients during RF surgery, and many improvements have been made from radiation source equipment to protective measures, physicians and scientists have long been working to find methods and equipment for fully 3D-guided surgery, with early success.
The current electroanatomical scaling systems are the non-contact balloon scaling systems EnSite Array and EnSite NavX, which can greatly reduce X-ray exposure time during RF ablation treatment of supraventricular tachycardia, atrial tachycardia, ventricular tachycardia, atrial flutter and other arrhythmias. The EnSite Array, a non-contact balloon calibrated system, uses non-contact electrodes to measure the spatial electric field, capturing 3,360 points on the wall of the heart chamber at each instant and representing them on an isopotential map to determine the mechanism of the arrhythmia and guide the ablation catheter to the exact location, greatly reducing arrhythmias, especially atrial tachycardia, ventricular tachycardia and atrial flutter. The procedure time for complex arrhythmias such as atrial tachycardia, atrial fibrillation, etc., shortens the X-ray fluoroscopy time and improves the success rate. The EnSite NavX system is another important platform for addressing complex arrhythmias, and works on the same principle of using spatial electric field technology to locate electrode catheters, with the advantage of realistically reconstructing the anatomy of the circulatory system (including blood vessels and the heart) and clearly displaying the catheters placed in blood vessels and heart chambers. The position of the catheter in the vascular and cardiac chambers is clearly shown. This provides the basis for the NavX system to perform electrophysiology and surgery with zero fluoroscopy. This means a revolution for electrophysiological markers and ablation therapy.
Data from several foreign and domestic electrophysiology centers show that the time to complete electrophysiological examination and RF ablation procedures with the NavX system guided by zero fluoroscopy is not significantly different from that of conventional X-ray fluoroscopy, the success rate of the procedures is not significantly different, and the recurrence rate at postoperative follow-up is similar, and no serious complications have been reported individually so far.
The use of the NavX system to guide electrophysiological examinations and radiofrequency ablation procedures with zero fluoroscopy is beneficial to both the child and the physician, especially since the majority of patients with supraventricular tachycardia are adolescents and children, and avoiding radiation damage to children is a high concern for all physicians. In terms of cost, the NavX system is more expensive than conventional methods, but because the NavX system can mark the site of catheterization, it can save some of the catheters used for localization. In fact, the additional cost of using the NavX system is clearly worth it for the increased safety and reduced radiation exposure of the procedure.