2026 Volume 8 Issue 9 Pages 1404-1411
Background: We aimed to assess the effectiveness and safety of a new filtering feature (Spot ROITM, Canon Medical Systems, Japan) in reducing radiation exposure during radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF).
Methods and Results: The study involved 2 steps: (1) an ex vivo experiment to evaluate the radiation reduction of Spot ROITM(SROI); (2) a clinical study with 69 consecutive patients undergoing initial AF-RFCA, divided into conventional collimation (CC) and SROI groups. All procedures used 3-dimensional electroanatomical mapping guidance. In the ex vivo model, SROI reduced radiation exposure by 66.7%. Clinically, all predefined procedures were successful, with similar complication rates between groups (CC vs. SROI, 3.2% vs. 2.6%; P=0.88). The dose–area product for patients (CC vs. SROI: 17.5 [12.8–25.4] vs. 5.6 [3.6–9.8] Gy · cm2, P<0.001) and scattered radiation at the operator’s chest level (13.0 [10.3–18.5] vs. 3.0 [1.8–5.3] µSv, P<0.001) were significantly lower with SROI. Procedural time (150 [125–167] vs. 150 [120–183] min, P=0.89), fluoroscopy time (13.6 [10.7–18.9] vs. 12.6 [9.6–15.2] min, P=0.09), and short- to intermediate-term recurrence rates were comparable between groups.
Conclusions: SROI reduced the radiation exposure of both patients and operators without compromising procedural success, complication rates or recurrence rates.
