Key result
Zero-fluoroscopy PFA using 4D ICE achieves procedural success in a single patient with symptomatic AF.
Why the study?
Is zero-fluoroscopy pulsed-field ablation using 4D intracardiac echocardiography feasible and efficient for the treatment of symptomatic atrial fibrillation?
Case Report (n=1)
Is zero-fluoroscopy pulsed-field ablation using 4D intracardiac echocardiography feasible and efficient for the treatment of symptomatic atrial fibrillation?
Zero-fluoroscopy pulsed-field ablation guided by 4D intracardiac echocardiography is a feasible and efficient approach for treating atrial fibrillation.
Intracardiac echocardiography (ICE) is a common tool that has real-time impact in novel pulsed-field ablation (PFA). It is a feasible and efficient option due to zero-fluoroscopy, real-time tissue visualization of procedural maneuvers, and for the assessment of potential procedural complications. We present a case of zero-fluoroscopy-based PFA using four-dimensional (4D) ICE in a 68-year-old man with symptomatic atrial fibrillation. Using 4D ICE, we were able to achieve procedural success by visualization of direct tissue contact with the Farawave™ catheter (Boston Scientific, Marlborough, MA, USA) with each rotation and application of the basket and flower configurations and no edema or color change in tissue morphology after applications. Overall, zero fluoroscopy in PFA is feasible and efficient.
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Harmouch et al. (2025) conducted a case report in symptomatic atrial fibrillation (n=1). Zero-fluoroscopy pulsed-field ablation (PFA) using 4D intracardiac echocardiography (ICE) was evaluated on procedural success. Zero-fluoroscopy pulsed-field ablation using 4D intracardiac echocardiography achieved procedural success in 1 patient (a 68-year-old man) with symptomatic atrial fibrillation.
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