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All Journal Narra J Plexus Medical Journal JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia
Muhammad Farid Hamka
Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Zero-fluoroscopy versus fluoroscopy-guided catheter ablation in ventricular arrhythmia: A systematic review and meta-analysis Irnizarifka Irnizarifka; Christopher D. Tristan; Matthew A. Wijayanto; Risalina Myrtha; Kyra Modesty; Annisa A. Rahma; Enrico A. Budiono; Awalil R. K. Rahman; Muhammad Farid Hamka; Muhana F. Ilyas
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.
Humeral Capitellum Fracture Bryan-Morrey Type IV Performed Open Reduction Internal Fixation Treatment: A Rare Case Report Fajar Ivan Effendi; Christopher Daniel Tristan; Awalil Rifqi Kurnia Rahman; Muhammad Farid Hamka; Aininna ‘Izzah Zafira; Hikam Yanwar Pradana
Plexus Medical Journal Vol. 5 No. 1 (2026): Februari
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v5i1.3242

Abstract

Introduction: Capitellum fracture is a very rare fracture with an incidence of 1% of fracture cases in the elbow area and 6% of all fracture cases in the distal humerus area. Case Report: A 41-year-old man presented to the emergency room with left elbow pain after a fall and unable to move his arm. An X-ray revealed a lateral condyle fracture (Milch type 2) with joint dislocation and soft tissue swelling. However, a CT scan showed a different fracture extending from the capitellum to the trochlear (Bryan Morrey type IV or McKee fracture). She underwent successful ORIF with K-wires, experiencing sharp pain post- procedure but recovering well overall. Discussion: The rarity of capitellum fractures is due to its protected position behind the radial head, humeral trochlea, and humeral collateral ligaments. Specific radiographic signs, like the double arc sign on lateral X-rays, are crucial for diagnosis. This sign should not be overlooked and should be confirmed by a pre-operative 3D CT scan to prevent misdiagnosis. Treatment typically involves ORIF, ideally with a Herbert screw, although K-wires can be used as an alternative in certain circumstances. Conclusion: Capitellum fracture is a very rare injury. Before surgery, a CT scan and 3D reconstruction should be conducted to evaluate the anatomy and accurately classify the fracture. The Herbert screw is considered the optimal treatment, but in emergencies or when cost is a concern, K-wires can be a suitable alternative.
Outcomes of True Zero-Fluoroscopy Catheter Ablation for Atrial Fibrillation Care: A Systematic Review and Meta-analysis Nathania Ella Sudiono; Christopher Daniel Tristan; Muhammad Farid Hamka; Erlangga Masykur Kynaya; Awalil Rifqi Kurnia Rahman; Irnizarifka Irnizarifka
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 12 No 3 (2026): JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol. 12.3 (2026)
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53366/jimki.v12i3.1103

Abstract

Introduction: Atrial fibrillation (AF) represents the most common arrhythmia. Current guidelines recommending catheter ablation as first-line rythm control and definitive treatment for AF which resistant or unresponsive to antiarrhythmic drugs. However, there is concerning issue of fluoroscopy radiation regarding conventional catheter ablation. Zero-fluoroscopy (ZF) emerged as novel technique to fully eliminated fluoroscopy with uncertainity of efficacy and safety. Previous review was insufficient, as they grouped fluoroless ablation under the ZF category. Method: Scopus, Pubmed, ScienceDirect, and CENTRAL were used to identify relevant studies prior to December 21, 2024. Studies directly comparing TZF vs NZF were included. Quality assessment was carried out using the RoB 2.0 and ROBINS-I tool. Meta-analysis was conducted using R-Studio. Discussion: There were one randomized controlled trial (RCT) and seven non-randomized cohorts (1.171 patients) included. The success of pulmonary vein isolation (PVI) with TZF and NZF was comparable, with follow-up visits showing equivalent AF recurrence rates at 6 months (RR = 1.00; 95% CI = 0.90 - 1.11; p = 0.99) and 12 months (RR = 0.57; 95% CI = 0.13 – 2.57; p = 0.47). ZF showed a significantly shorter procedural time duration (MD = -8.94; 95% CI = -13.56 – (-4.32); p < 0.01). Safety evaluation of ZF demonstrated comparable results for cardiac tamponade (RR = 1.77; 95% CI = 0.37 – 8.37; p = 0.47) and other adverse events risk. Conclusion: TZF technique in catheter ablation for AF is a revolutionary, effective, and safe innovation. TZF should be considered the standard approach in AF catheter ablation.
Co-Authors Aininna ‘Izzah Zafira Annisa A. Rahma Awalil R. K. Rahman Awalil Rifqi Kurnia Rahman Christopher D. Tristan Christopher Daniel Tristan Enrico A. Budiono Erlangga Masykur Kynaya Fajar Ivan Effendi Hikam Yanwar Pradana Irnizarifka Irnizarifka Irnizarifka Irnizarifka Kyra Modesty Matthew A. Wijayanto Muhana F. Ilyas Nathania Ella Sudiono Risalina Myrtha