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Zero and near-zero fluoroscopic ablation of cardiac arrhythmias: A review of green electrophysiology

Ziyu Wang, Zefeng Wang,Yongquan Wu

Radiofrequency catheter ablation is currently a first-line therapy for most cardiac tachyarrhythmias. Fluoroscopy harm for patients and medical staffs in the electrophysiology laboratory has for long-time been an issue of concern. For last decades, many measures have risen for zero and near-zero fluoroscopic ablation of cardiac arrythmias (green electrophysiology) including new Three-Dimensional Electro- Anatomical Mapping (3D-EAM) software, and Intracardiac Echocardiography (ICE) as most popular technologies. Recent years, some electrophysiologists innovated existing technologies and successfully achieved complete zero fluoroscopy, such as T3D (total three-dimension) and EAM-ICE, which make green electrophysiology more widely spread and used. However, fluoroscopy still plays a pivotal role in radiofrequency ablation in a wide range. Current methods have both advantages and disadvantages. The combination of existing technologies has pointed out a trend of green electrophysiology. All in all, the development prospect of green electrophysiology is bright in the future.