Left atrial intracardiac echocardiography during pulsed field ablation improved visualization and reduced pulmonary vein isolation time compared with right atrial placement (19.6 vs 25.4 min, p=0.01).
Cohort (n=53)
Does left atrial intracardiac echocardiography placement improve procedural efficiency and visualization compared to right atrial placement during pulsed field ablation for atrial fibrillation?
Left atrial placement of intracardiac echocardiography during pulsed field ablation for atrial fibrillation improves visualization and reduces procedural times compared to right atrial placement.
Absolute Event Rate: 19.6% vs 25.4%
p-value: p=0.01
ABSTRACT Background Pulsed field ablation (PFA) is an emerging, effective therapy for atrial fibrillation (AF). Achieving adequate catheter‐to‐tissue contact is crucial, as poor contact can result in pulmonary vein (PV) reconnection or hemolysis. Intracardiac echocardiography (ICE) enables real‐time visualization of the PFA catheter and PV anatomy. To compare the utility of left atrial (LA) versus right atrial (RA) ICE placement during PFA for AF. Methods We retrospectively analyzed 53 consecutive AF patients who underwent index PFA procedures (FARAWAVE, Boston Scientific). Patients were stratified into two groups according to ICE location: RA‐ICE ( n = 20) and LA‐ICE ( n = 33). Procedural characteristics and image quality of catheter and PV anatomy were evaluated. Results The total number of PFA applications was higher in the LA‐ICE group than in the RA‐ICE group (45.6 ± 6.8 vs. 35.8 ± 3.4, p < 0.01). Nevertheless, LA‐ICE was associated with a shorter LA dwell time (45.4 ± 13.3 vs. 55.0 ± 17.1 min, p = 0.04) and PV isolation time (19.6 ± 3.9 vs. 25.4 ± 10.5 min, p = 0.01). Visualization of catheter configuration and PV anatomy was significantly better in the LA‐ICE group, particularly for the left inferior and right‐sided PVs ( p < 0.01). Conclusions ICE placement in the LA improved visualization of the PFA catheter and PV anatomy, resulting in reduced PV isolation and LA dwell times compared with RA‐ICE.
Kimura et al. (Mon,) conducted a cohort in Atrial fibrillation (n=53). Left atrial intracardiac echocardiography (LA-ICE) vs. Right atrial intracardiac echocardiography (RA-ICE) was evaluated on Pulmonary vein isolation time (minutes) (p=0.01). Left atrial intracardiac echocardiography during pulsed field ablation improved visualization and reduced pulmonary vein isolation time compared with right atrial placement (19.6 vs 25.4 min, p=0.01).