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Zero-fluoroscopy versus fluoroscopy-guided catheter ablation in ventricular arrhythmia: A systematic review and meta-analysis Irnizarifka, Irnizarifka; Tristan, Christopher D.; Wijayanto, Matthew A.; Myrtha, Risalina; Modesty, Kyra; Rahma, Annisa A.; Budiono, Enrico A.; Rahman, Awalil R. K.; Hamka, Muhammad Farid; Ilyas, Muhana F.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narraj.v5i2.2094

Abstract

Catheter ablation has been the go-to treatment for ventricular arrhythmia, with traditional fluoroscopy-guided and non-zero fluoroscopy (NZF) catheter ablation posing high radiation risk for operators and patients. Zero-fluoroscopy technique offers elimination of radiation risk; however, its efficacy and safety in ventricular arrhythmia patients are not well explored. The aim of this study was to systematically evaluate the effectiveness, safety, and feasibility of zero-fluoroscopy ablation on ventricular arrhythmia patients. This study only included relevant studies comparing zero-fluoroscopy and NZF in ventricular arrhythmia ablation that were identified from Scopus, PubMed, and ScienceDirect (up to June 20, 2024). The quality of the study was assessed using the ROBINS-I tool, and the meta-analysis was conducted using a random-effect model. Out of 383 studies found, nine cohort studies were included with 1.408 patients. There was no significant difference in the acute procedural success rate of the zero-fluoroscopy and NZF (relative risk: 1.01; 95%CI: 0.95–1.07; p=0.69), with a similar recurrence rate (p=0.88; for four studies; n=374), and comparable procedural time (mean difference: -19.22 minutes; 95%CI: -41.16–2.72; p=0.09). Adverse events such as pericardial effusion, pseudoaneurysm, and hematoma were similar between zero-fluoroscopy and NZF. Overall, zero-fluoroscopy catheter ablation has demonstrated non-inferiority as a treatment option for ventricular arrhythmia ablation. As zero-fluoroscopy eliminates radiation risk without compromising procedural efficacy, zero-fluoroscopy has the potential to become a widely adopted approach for catheter ablation in ventricular arrhythmia.
Hybrid Procedural Management of Multiple Pulmonary Arteriovenous Malformations In A Patient With Hereditary Hemorrhagic Telangiectasia: A Case Report Sanubari, Aulia Agung; Budiono, Enrico A.; Prasetyo, Arif
Jurnal Locus Penelitian dan Pengabdian Vol. 3 No. 10 (2024): Jurnal Locus Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v3i10.3216

Abstract

Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by vascular malformations, including Pulmonary Arteriovenous Malformations (PAVMs), which can lead to serious complications such as dyspnea and hemorrhage. This report features a 37-year-old woman with HHT and multiple PAVMs. The diagnosis was established through physical examination, laboratory tests, and thoracic multislice computed tomography (MSCT). A hybrid management approach was applied, including embolization and thoracotomy. The patient underwent successful embolization of the inferior segment, followed by thoracotomy to overcome procedural difficulties. After the intervention, the patient's symptoms improved significantly, with no recurrence. Management of complex PAVMs may require a combination of methods, including embolization and surgery. The importance of early detection and adaptive management in HHT patients is expressed, given the high risk of complications. Embolization is the primary treatment for PAVMs, but in complex cases, surgical intervention is required. This study emphasizes the importance of a hybrid management approach and early detection in preventing serious complications in HHT patients, as well as the need for the development of better clinical guidelines for the management of PAVMs.