Prevalence of sustained atrial arrythmias and treatment with zero fluoroscopy or near zero fluoroscopy catheter ablation in Slovenian orthotopic heart transplant recipients

Abstract Funding Acknowledgements Type of funding sources: None. Background Due to advances in surgical techniques and immunosuppression survival heart transplant (HT) recipients has improved significantly, with that the prevalence sustained atrial arrhythmias (SAA) these patients is increasing. In HT antiarrhythmic therapy options are limited. Radiofrequency ablation (RFA) represents a viable but underutilized option after other etiologies SAA such as acute allograft rejection vasculopathy excluded. Limiting radiation exposure recipients, who exposed 3,5 times (1) greater dose compared general population significantly more susceptible develop malignancies, essential. Purpose Our aim was analyse type Slovenian orthotopic feasibility procedural outcomes zero (ZF) or near fluoroscopy (NZF) RFA treatment approaches. Methods We performed retrospective analysis between 2002 2022. re-evaluated all available ECGs suspected included for presence SAA. further analysed underwent at our centre. All procedures were primarily 3D electroanatomical mapping system intracardiac echocardiography guidance. Either ZF NZF approaches used. The primary endpoint termination success deemed when subsequent attempts reinduce failed. Long-term defined absence any spontaneous during 12-month follow-up. Results Among 364 consecutive 19 (5,2%) evaluated Of those 7 (37%) presented typical flutters (AFL), 9 (47%) atypical AFL, 2 (11%) focal tachycardia (FAT) 1 (5%) slow-fast atrioventricular nodal reentry tachycardia. result rejection. 10 (53%) occurred first 3 months HT. remaining late, median 6,6 years (25th-75th IQR: 7,7 years). patients. acutely successful however additional needed long-term success. all, (Table 1). cases had macro micro reentrant AFL 2,0 re-entry circuits mapped 3,3 circuits) procedure – cavotricuspid isthmus perimitral several right atrium (RA) scar-related incision related AFL. RA FAT ablated. Five (50%) ZF. No major complications observed. Conclusion appears be feasible safe, still underutilised, option. case series demonstrates favourable larger data support results.