F-27 | Safety and Efficacy of Minimal Fluoroscopic Imaging Technique vs Conventional Imaging Technique for Patients With Atrial Arrhythmias Undergoing Catheter Ablation: A Meta-Analysis of Randomised Controlled Trials

Background: The implementation of a minimal or zero-fluoroscopy approach for catheter ablation in atrial fibrillation (AF) treatment offers a safer alternative to conventional fluoroscopy.Methods: MEDLINE, Embase, Cochrane Library, and Web of Science databases were systematically searched to identify relevant RCTs.Odds ratio (OR), risk ratios (RRs), and standardized mean differences (SMD) with 95% CIs were pooled using the Mantel-Haenszel random effects model.Results: A total of 14 studies with 1927 patients were included.The pooled analysis showed no significant difference and non-inferiority in acute procedural success between minimal fluoroscopic and conventional approaches [RR: 1.01, 95% CI: 0.99-1.03,p 0.35].Similarly, no significant difference or non-inferiority was found in periprocedural complications [RR: 1.05, 95% CI: 0.61-1.82,p 0.86], long-term atrial arrhythmia recurrence [RR: 0.98, 95% CI: 0.67-1.45,p 0.94], or total procedure time [MD: -3.29 minutes, 95% CI: -15.85 to 8.98].However, fluoroscopy time was markedly reduced [MD: -10.64 minutes, 95% CI: -13.83 to -7.45, p < 0.0001], and radiation exposure was significantly lower in the minimal approach group [SMD: -1.62, 95% CI: -2.34 to -0.90, p < 0.0001].Conclusions: This meta-analysis shows the minimal fluoroscopic approach is non-inferior to the conventional approach in terms of acute procedural success, periprocedural complications, long-term atrial arrhythmia recurrence, and total procedure time.However, it significantly reduces fluoroscopy time and radiation exposure, highlighting its potential as a safer alternative while maintaining procedural efficacy.