Combined use of electro-anatomic mapping system and intracardiac echocardiography to achieve zero-fluoroscopy catheter ablation for treatment of paroxysmal atrial fibrillation: a single centre experience

2019 ◽  
Vol 36 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Matevž Jan ◽  
David Žižek ◽  
Dimitrij Kuhelj ◽  
Nikola Lakič ◽  
Tine Prolič Kalinšek ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Intracardiac Echocardiography ◽  
Single Centre ◽  
Combined Use ◽  
Mapping System ◽  
Single Centre Experience ◽  
Zero Fluoroscopy

scholarly journals Study on the Curative Effect and Safety of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation via Zero-Fluoroscopy Transseptal Puncture under the Dual Guidance of Electroanatomical Mapping and Intracardiac Echocardiography

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Fei Hang ◽  
Liting Cheng ◽  
Zhuo Liang ◽  
Ruiqing Dong ◽  
Xinlu Wang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Radiofrequency Catheter Ablation ◽  
Intracardiac Echocardiography ◽  
Transseptal Puncture ◽  
Electroanatomical Mapping ◽  
Curative Effect ◽  
Significant Difference ◽  
Zero Fluoroscopy

Aims. 3D electroanatomical mapping combined with intracardiac echocardiography- (EAM-ICE-) guided transseptal puncture has been proven safe and effective during the radiofrequency catheter ablation (RFCA) procedure used to treat paroxysmal atrial fibrillation (PAF). In this study, we aimed to compare the curative effect and safety of RFCA via F (fluoroscopy) and zero-fluoroscopy transseptal puncture guided by EAM-ICE in patients with PAF. Methods and Results. A prospective study in which 110 patients with PAF were included and assigned to two groups was conducted. Fifty-five (50%) patients were enrolled in the EAM-ICE group, whereas the other 55 (50%) patients were enrolled in the F group. There were no significant differences in baseline characteristics between the two groups. The transseptal duration time was longer in the EAM-ICE group (19.8 ± 3.0 min vs. 8.6 ± 1.2 min, p ≤ 0.01 ); however, fluoroscopy was not used in the EAM-ICE group compared with the F group (0 mGy vs. 109.1 ± 57.9 mGy). Similarly, there was also no significant difference in the recurrence rate of atrial fibrillation between the EAM-ICE and F groups (25.5% vs. 18.2%, p = 0.356 ). Conclusion. RFCA via EAM-ICE-guided zero-fluoroscopy transseptal puncture in patients with PAF is safe and effective for long-term follow-up.

scholarly journals Zero fluoroscopy cryballoon catheter ablation of paroxysmal atrial fibrillation

2021 ◽  
Vol 27 (4) ◽  
pp. 12-16
Author(s):  
E. B. Kropotkin ◽  
E. A. Ivanitskiy ◽  
D. A. Shlyakov ◽  
Yu. V. Ivanitskaya ◽  
V. A. Sakovich
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Cryoballoon Ablation ◽  
Drug Resistant ◽  
Safety And Efficacy ◽  
Zero Fluoroscopy

To assess safety and efficacy of nonfluoroscopic cryoballoon ablation, 32 patients with symptomatic drug resistant paroxysmal atrial fibrillation were treated.

scholarly journals Outcome and safety of intracardiac echocardiography guided left atrial appendage closure within zero-fluoroscopy atrial fibrillation ablation procedures

2021 ◽  
Author(s):  
yi he chen ◽  
Liangguo Wang ◽  
Xiaodong Zhou ◽  
ying fang ◽  
Lan Su ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Intracardiac Echocardiography ◽  
Atrial Appendage ◽  
Adverse Event Rate ◽  
Left Atrial Appendage Closure ◽  
Zero Fluoroscopy

Background: Simultaneous atrial fibrillation (AF) catheter ablation and left atrial appendage closure (LAAC) is sometimes recommended for both rhythm control and stroke prevention. However, the advantages of intracardiac echocardiography (ICE) guidance for this combined procedure have been scarcely reported. To evaluate the clinical outcomes and safety of ICE guided LAAC within a zero-fluoroscopy catheter ablation procedure. Methods and Results:From April 2019 to April 2020, 56 patients with symptomatic AF underwent concomitant catheter ablation and LAAC. ICE with a multi-angled imaging protocol mimicking the TEE echo windows was used to guide LAAC. Successful radiofrequency catheter ablation and LAAC was achieved in all patients. Procedure-related adverse event rate was 3.6%. During the 12-month follow-up, 77.8% of patients became free of arrhythmia recurrences and oral anticoagulants were discontinued in 96.4% of patients. No ischemic stroke occurred despite two cases of device-related thrombosis versus an expected stroke rate of 4.8% based on the CHA2DS2-VASc score. The overall major bleeding events rate was 1.8%, which represented a relative reduction of 68% versus an expected bleeding rate of 5.7% based on the HAS-BLED score of the patient cohort. The incidence of iatrogenic atrial septal defect secondary to a single transseptal access dropped from 57.9% at 2 months to 4.2% at 12 months TEE follow-up. Conclusion:The combination of catheter ablation and LAAC under ICE guidance was safe and effective in AF patients with high stroke risk. ICE with our novel protocol was technically feasible for comprehensive and systematic assessment of device implantation.

scholarly journals Zero-Fluoroscopy Cardiac Ablation: Technology Is Moving Forward in Complex Procedures—A Novel Workflow for Atrial Fibrillation

Biology ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1333
Author(s):  
Matteo Bertini ◽  
Graziella Pompei ◽  
Paolo Tolomeo ◽  
Michele Malagù ◽  
Alessio Fiorio ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Gold Standard ◽  
Intracardiac Echocardiography ◽  
The Other ◽  
Transseptal Puncture ◽  
Healthcare Staff ◽  
Af Ablation ◽  
Mapping System ◽  
Long Time ◽  
Zero Fluoroscopy

Background and Rationale. A fluoroscopy-based approach to an electrophysiological procedure is widely validated and has been recognized as the gold standard for a long time. The use of fluoroscopy exposes both the healthcare staff and the patient to a non-negligible dose of radiation. To minimize the risks associated with the use of fluoroscopy, it would be reasonable to perform ablation procedures with zero fluoroscopy. This approach is widely used in simple ablation procedures, but not in complex procedures. In atrial fibrillation (AF) ablation procedures, fluoroscopy remains the main technology used, in particular to guide the transseptal puncture. Main results and Implications. We present a workflow to perform a complete zero-fluoroscopy ablation for AF ablation procedures using a 3D electro-anatomical mapping system, intracardiac echocardiography and a novel steerable guiding sheath that can be visualized on the mapping system. We present two cases, one with paroxysmal AF and the other one with persistent AF during which we applied this novel workflow achieving a successful pulmonary vein isolation without complications and complete zero-fluoroscopy exposure.

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