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Abstract：
Fluoroscopy has always been the cornerstone imaging method of interventional cardiology procedures. However, radiation exposure is linked to an increased risk of malignancies and multiorgan diseases. The medical team is even more exposed to X-rays, and a higher incidence of malignancies was reported in this professional group. In the last years, X-ray exposure has increased rapidly, involving, above all, the medical team and young patients and forcing alternative fluoroless imaging methods. In cardiac electrophysiology (EP) and pacing, the advent of 3D electroanatomic mapping systems with dedicated catheters has allowed real-time, high-density reconstruction of both heart anatomy and electrical activity, significantly reducing the use of fluoroscopy. In addition, the diffusion of intracardiac echocardiography has provided high anatomical resolution of moving cardiac structures, providing intraprocedural guidance for more complex catheter ablation procedures. These methods have largely demonstrated safety and effectiveness, allowing for a dramatic reduction in X-ray delivery in most arrhythmias\' ablations. However, some technical concerns, as well as higher costs, currently do not allow their spread out in EP labs and limit their use to only procedures that are considered highly complex and time-consuming and in young patients. In this review, we aim to update the current employment of fluoroless imaging in different EP procedures, focusing on its strengths and weaknesses.
摘要：
透视检查一直是介入心脏病学程序的基础成像方法。然而,辐射暴露与恶性肿瘤和多器官疾病的风险增加有关。医疗团队更容易受到X光的照射,据报道，该专业人群中恶性肿瘤的发病率较高。在过去的几年里，X射线暴露量迅速增加,涉及,最重要的是,医疗团队和年轻患者，并迫使替代非荧光成像方法。在心脏电生理学（EP）和起搏中，带有专用导管的3D电解剖标测系统的出现允许实时，心脏解剖和电活动的高密度重建，显著减少透视的使用。此外,心内超声心动图的扩散为运动的心脏结构提供了较高的解剖学分辨率，为更复杂的导管消融程序提供术中指导。这些方法在很大程度上证明了安全性和有效性，允许在大多数心律失常消融中X射线输送显著减少。然而,一些技术问题，以及更高的成本，目前不允许其在EP实验室中传播，并将其使用限制在仅被认为高度复杂且耗时且适用于年轻患者的程序。在这次审查中,我们的目标是更新目前不同EP程序中无氟成像的使用情况，专注于它的优点和缺点。
