{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:25:36Z","timestamp":1789421136821,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T00:00:00Z","timestamp":1630368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Radiofrequency catheter ablation for cardiac arrhythmias has traditionally been guided by fluoroscopy. Fluoroscopy exposes the patient, operator, and staff to ionizing radiation which has no safe dose void of stochastic and deterministic biologic risks. Zero fluoroscopy (ZF) approaches for catheter ablation have been advocated to eliminate these risks. We conducted a meta\u2010analysis comparing acute procedure success, recurrence\u2010free survival, complications, and procedure times between the approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a literature search from inception through December 2020 in the databases of EMBASE and MEDLINE. We included randomized controlled trials and cohorts that compared the outcomes of interest in ZF and conventional\/low fluoroscopy (CF\/LF) approaches. The outcomes sought were acute procedure success, recurrence\u2010free survival, complications, and procedure times. Effect estimates were combined, using the random\u2010effects, generic inverse variance method of DerSimonian and Laird.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen studies from 2013 to 2020, including 6052 patients (2219 ZF, 3833 CF\/LF) were included. There were no significant differences in acute procedure success rate (odds ratio [OR]: 1.10, 95% confidence interval [CI]: 0.75\u20131.59), recurrence\u2010free survival (OR: 1.08, 95% CI: 0.78\u20131.49), periprocedural complication rate (OR: 0.72, 95% CI: 0.45\u20131.16), or total procedure time (weighted mean difference 2.32\u2009min, 95% CI: \u22122.85\u20137.50) between ZF and CF\/LF approaches, respectively. Overall, only 1.26% of patients crossed over from ZF to CF\/LF arm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Periprocedural and postprocedural outcomes with a ZF approach compared favorably with traditional fluoroscopic guidance without increasing procedural times. As comfort with ZF grows, coupled with evolving mapping technologies, this method has potential to become the standard approach for catheter ablation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15221","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T14:29:46Z","timestamp":1629815386000},"page":"2761-2776","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Zero fluoroscopy approach versus fluoroscopy approach for cardiac arrhythmia ablations: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8222-550X","authenticated-orcid":false,"given":"Chanavuth","family":"Kanitsoraphan","sequence":"first","affiliation":[{"name":"Internal Medicine Residency Program University of Hawaii John A Burns School of Medicine  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chol","family":"Techorueangwiwat","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program University of Hawaii John A Burns School of Medicine  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pattara","family":"Rattanawong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0959-5576","authenticated-orcid":false,"given":"Jakrin","family":"Kewcharoen","sequence":"additional","affiliation":[{"name":"Internal Medicine Residency Program University of Hawaii John A Burns School of Medicine  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karnika","family":"Ayinapudi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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