Zero-fluoroscopy radiofrequency catheter ablation: results from Hanoi Heart Hospital

Objective: To evaluate the clinical and procedural characteristic, efficacy and safety of catheter ablation of cardiac arrhythmias using a three-dimensional (3D) electro-anatomical mapping system without fluoroscopy at Hanoi Heart Hospital. Methods: This cross-sectional study with follow-up included 97 patients who underwent electrophysiological study and catheter ablation using a 3D electroanatomical mapping system without fluoroscopy at Hanoi Heart Hospital from January to December 2025. The treated arrhythmias included premature ventricular contractions (PVCs), atrioventricular nodal reentrant tachycardia (AVNRT), Wolff–Parkinson–White (WPW) syndrome, atrioventricular reentrant tachycardia (AVRT), atrial tachycardia (AT), and ventricular tachycardia (VT). Clinical characteristics, procedural duration, ablation time, procedural success, complications, and arrhythmia recurrence during follow-up were recorded. Results: The mean age was 47.0 ± 17.5 years, and 66.0% of patients were female. PVCs were the most common arrhythmia (53.6%), followed by AVNRT (22.7%) and WPW syndrome (12.5%). The mean procedure duration was 47.2 ± 12.1 minutes, while the mean ablation time was 266.0 ± 155.8 seconds. Overall procedural success was achieved in 96 of 97 patients (98.9%). No cases of cardiac tamponade, pneumothorax, coronary spasm, persistent complete atrioventricular block, or vascular complications at the access site were recorded. One patient developed transient atrioventricular block, which recovered spontaneously, and two patients experienced transient right bundle branch block. Five patients had model displacement (5,15%), necessitating re-mapping. During a median follow-up of 10 (7–13) months, two cases of arrhythmia recurrence were documented. Conclusion: Catheter ablation of cardiac arrhythmias using a 3D electroanatomical mapping system without fluoroscopy was feasible in selected patients, with a high procedural success rate and a low rate of complications. Pre-procedure preparation is crucial to avoid model displacement.