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Cost Optimization When Using 3-D Mapping Systems for a Non-fluoroscopic EP Lab

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Abstract

There is a wider adoption of 3-D mapping systems all around the world, to decrease (ALARA: as low as reasonable achievable) or to eliminate fluoroscopy in the electrophysiology (EP) lab. These systems need the use of proprietary either patches or catheters that increases the cost of the EP procedures. For arrhythmias involving the so-called complex substrates, it is now widely acceptable to use these 3-D mapping systems as a standard of care. Cost seems to be a barrier to expand 3-D mapping systems utilization to simple substrates or to all cases at the EP lab. We discuss different components of cost while using these systems, and we describe how we do manage to constraint cost to expand 3-D use to every substrate and to become a routine utilization in our EP lab.

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References

  1. Ayala Valani L, Al Baridi E, Rivera S, Brambilla C, Brahim Y, Klein A, Coluccini P, Compagno P, Fortes Etchepare R, Badra M, Dusault C, Roux JF, Ayala Paredes F. Real life EP lab without fluoroscopy. Eur Heart J. 2018;39(Suppl 1):P6646.

    Google Scholar 

  2. Fernández-Gómez JM, Moriña-Vázquez P, Morales Edel R, Venegas-Gamero J, Barba-Pichardo R, Carranza MH. Exclusion of fluoroscopy use in catheter ablation procedures: six years of experience at a single center. J Cardiovasc Electrophysiol. 2014;25(6):638–44.

    Article  Google Scholar 

  3. Razminia M, Willoughby MC, Demo H, Keshmiri H, Wang T, D’Silva OJ, Zheutlin TA, Jibawi H, Okhumale P, Kehoe RF. Fluoroless catheter ablation of cardiac arrhythmias: a 5-year experience. Pacing Clin Electrophysiol. 2017;40(4):425–33.

    Article  Google Scholar 

  4. Sánchez JM, Yanics MA, Wilson P, Doshi A, Kurian T, Pieper S. Fluoroless catheter ablation in adults: a single center experience. J Interv Card Electrophysiol. 2016;45(2):199–207.

    Article  Google Scholar 

  5. Álvarez M, Bertomeu-González V, Arcocha MF, Moriña P, Tercedor L, Ferrero de Loma Á, Pachón M, García A, Pardo M, Datino T, Alonso C, Osca J, Investigators of the Spanish Multicenter registry of Fluoroscopy-free Ablation. Nonfluoroscopic catheter ablation. Results from a prospective multicenter registry. Rev Esp Cardiol. 2017;70:699–705.

    Article  Google Scholar 

  6. Casella M, Dello Russo A, Pelargonio G, et al. Near zerO fluoroscopic exPosure during catheter ablAtion of supRavenTricular arrhYthmias: the NO-PARTY multi-center randomized trial. Europace. 2016;18:1565–72.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072134/#sup1.

    Article  Google Scholar 

  7. Bigelow AM, Smith PC, Timberlake DT, et al. Procedural outcomes of fluoroless catheter ablation outside the traditional catheterization lab. Europace. 2017;19(8):1378–84.

    Article  Google Scholar 

  8. Mickelsen S, Mickelsen C, MacIndoe C, Jaramillo J, Bass S, West G, Kusumoto FM. Trends and patterns in electrophysiologic and ablation catheter reuse in the United States. Am J Cardiol. 2001;87(3):351–3.. A9

    Article  CAS  Google Scholar 

  9. Birnie D, Healey JS, Krahn AD, Ahmad K, Crystal E, Khaykin Y, Chauhan V, Philippon F, Exner D, Thibault B, Hruczkowski T, Nery P, Keren A, Redfearn D. Prevalence and risk factors for cervical and lumbar spondylosis in interventional electrophysiologists. J Cardiovasc Electrophysiol. 2011;22(9):957–60.

    Article  Google Scholar 

  10. Wenger NK. Women in cardiology : the US experience. Heart. 2005;91(3):277–9.

    Article  CAS  Google Scholar 

  11. Eckardt L, Frommeyer G, Sommer P, Steven D, Deneke T, Estner HL, Kriatselis C, Kuniss M, Busch S, Tilz RR, Bonnemeier H, von Bary C, Voss F, Meyer C, Thomas D, Neuberger HR. Updated survey on interventional electrophysiology: 5-year follow-up of infrastructure, procedures, and training positions in Germany. JACC Clin Electrophysiol. 2018;4(6):820–7.

    Article  Google Scholar 

  12. Marini M, Ravanelli D, Guarracini F, Del Greco M, Quintarelli S, Cima A, Coser A, Martin M, Valentini A, Bonmassari RA. Cost-effective analysis of systematically using mapping systems during catheter ablation procedures in children and teenagers. Pediatr Cardiol. 2018;39:1581–9. https://doi.org/10.1007/s00246-018-1933-5.

    Article  PubMed  Google Scholar 

  13. Ferrell M, Wolf CE 2nd, Ellenbogen KA, Wood MA, Clemo HF, Gilligan DM. Ethylene oxide on electrophysiology catheters following resterilization: implications for catheter reuse. Am J Cardiol. 1997;80(12):1558–61.

    Article  CAS  Google Scholar 

  14. Bathina MN, Mickelsen S, Brooks C, Jaramillo J, Hepton T, Kusumoto FM. Safety and efficacy of hydrogen peroxide plasma sterilization for repeated use of electrophysiology catheters. J Am Coll Cardiol. 1998;32(5):1384–8.

    Article  CAS  Google Scholar 

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Correspondence to Félix Ayala-Paredes .

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Moriña Vazquez, P., Ayala-Paredes, F. (2019). Cost Optimization When Using 3-D Mapping Systems for a Non-fluoroscopic EP Lab. In: Proietti, R., Wang, Y., Yao, Y., Zhong, G., Lin Wu, S., Ayala-Paredes, F. (eds) Cardiac Electrophysiology Without Fluoroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-16992-3_17

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  • DOI: https://doi.org/10.1007/978-3-030-16992-3_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16991-6

  • Online ISBN: 978-3-030-16992-3

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