Efficacy and Safety of a Novel Filtering Function to Reduce Radiation Exposure During Catheter Ablation for Atrial Fibrillation.

BACKGROUND: We aimed to assess the effectiveness and safety of a new filtering feature (Spot ROITM, Canon Medical Systems, Japan) in reducing radiation exposure during radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF). METHODS AND RESULTS: The study involved 2 steps: (1) an ex vivo experiment to evaluate the radiation reduction of Spot ROITM (SROI); (2) a clinical study with 69 consecutive patients undergoing initial AF-RFCA, divided into conventional collimation (CC) and SROI groups. All procedures used 3-dimensional electroanatomical mapping guidance. In the ex vivo model, SROI reduced radiation exposure by 66.7%. Clinically, all predefined procedures were successful, with similar complication rates between groups (CC vs. SROI, 3.2% vs. 2.6%; P=0.88). The dose-area product for patients (CC vs. SROI: 17.5 [12.8-25.4] vs. 5.6 [3.6-9.8] Gy · cm2, P<0.001) and scattered radiation at the operator's chest level (13.0 [10.3-18.5] vs. 3.0 [1.8-5.3] µSv, P<0.001) were significantly lower with SROI. Procedural time (150 [125-167] vs. 150 [120-183] min, P=0.89), fluoroscopy time (13.6 [10.7-18.9] vs. 12.6 [9.6-15.2] min, P=0.09), and short- to intermediate-term recurrence rates were comparable between groups. CONCLUSIONS: SROI reduced the radiation exposure of both patients and operators without compromising procedural success, complication rates or recurrence rates.