{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T13:00:24Z","timestamp":1789822824697,"version":"4.0.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Zero-fluoroscopy (ZF) catheter ablation eliminates radiation exposure via use of 3-dimensional electroanatomical mapping. We aimed to assess safety and efficacy of ZF catheter ablation in the treatment of supraventricular tachycardias (SVTs), examine learning-curve characteristics and to evaluate long-term results and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed clinical characteristics, procedural and follow-up data of 605 consecutive patients undergoing catheter ablation for SVT (atrioventricular nodal re-entry tachycardia, <jats:italic>n<\/jats:italic>\u2009=\u2009297; atrial flutter, <jats:italic>n<\/jats:italic>\u2009=\u2009241 and accessory pathway mediated tachycardia, <jats:italic>n<\/jats:italic>\u2009=\u200967) between June 2017 and September 2021. Procedures were either guided by conventional fluoroscopy (F, <jats:italic>n<\/jats:italic>\u2009=\u2009223) or by EnSite Precision mapping system (ZF, <jats:italic>n<\/jats:italic>\u2009=\u2009382) based on decision of the operating physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Acute procedural success rate exceeded 98% across all arrhythmia groups for both ZF and F techniques (ZF: 99%, F: 100%, <jats:italic>p<\/jats:italic>\u2009=\u2009NS). 63% of patients underwent ZF procedures. Complication rate was low (0.66%), occurring only in the F group. Conversion rate to fluoroscopy was 7.8%. ZF procedures took an average of 5.1\u2005min longer (ZF: 64.5\u2009\u00b1\u200924.3\u2005min vs. F: 59.4\u2009\u00b1\u200929\u2005min, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05), however ZF procedure times were reduced over time. At 3.2 years, total mortality was 7% with no significant difference between ZF and F. Deaths were not related to the procedures. Atrial flutter showed significantly higher recurrence in ZF compared to F (83% vs. 94%, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Catheter ablation of SVTs using zero-fluoroscopy approach have similar acute success, complication and mortality rate as conventional fluoroscopic interventions. However, we detected significantly higher long-term arrhythmia recurrence after ZF ablation of atrial flutter, meriting further investigation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1582753","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T05:31:48Z","timestamp":1752125508000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute and long-term procedural outcomes, arrhythmia recurrence and mortality after supraventricular arrhythmia ablation: a comparative study of fluoroscopy and zero-fluoroscopy guided techniques"],"prefix":"10.3389","volume":"12","author":[{"given":"Kamilla Luca","family":"D\u00e1vid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs","family":"Polg\u00e1r","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"B\u00f3gyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"B\u00e1ri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Marczell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuella","family":"Bogdan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zal\u00e1n","family":"Guly\u00e1s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam Franciska","family":"Tur\u00e1ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Papp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"El\u0151d J\u00e1nos","family":"Zsigmond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emese","family":"T\u00f3th-Zs\u00e1mboki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor Zolt\u00e1n","family":"Duray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC guidelines for the management of patients with supraventricular tachycardiaThe task force for the management of patients with supraventricular tachycardia of the European society of cardiology (ESC)","volume":"41","author":"Brugada","year":"2020","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e506","DOI":"10.1161\/CIR.0000000000000311","article-title":"2015 ACC\/AHA\/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American college of cardiology\/American heart association task force on clinical practice guidelines and the heart rhythm society","volume":"133","author":"Page","year":"2016","journal-title":"Circulation"},{"key":"B3","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1161\/01.CIR.0000157946.29224.5D","article-title":"ACCF\/AHA\/HRS\/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures: a report of the American college of cardiology foundation\/American heart association\/American college of physicians task force on clinical competence and training","volume":"111","author":"Hirshfeld","year":"2005","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1093\/eurheartj\/eht394","article-title":"The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC associations of cardiovascular imaging, percutaneous cardiovascular interventions and electrophysiology","volume":"35","author":"Picano","year":"2014","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/s0735-1097(98)00047-3","article-title":"ACC Expert consensus document. 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