Phased‐Array Intracardiac Echocardiography During Pulmonary Vein Isolation and Linear Ablation for Atrial Fibrillation
Why the study?
Does phased-array intracardiac echocardiography provide utility for anatomic guidance during radiofrequency ablation for atrial fibrillation?
Population
29 patients undergoing pulmonary vein isolation or linear left atrial radiofrequency ablation for atrial…
Comparison
Real-time, phased-array intracardiac… vs Venography
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
ICE may aid PV mapping catheter guidance in AF ablation but not linear positioning; leaves open its routine role pending prospective trials.
Key Points
- To evaluate the clinical utility of real-time phased-array intracardiac echocardiography during pulmonary vein isolation and linear radiofrequency ablation for atrial fibrillation.
- Assessed 29 patients undergoing radiofrequency ablation for atrial fibrillation via pulmonary vein isolation (N=16) or linear left atrial ablation (N=13).
- Applied phased-array intracardiac echocardiography to visualize cardiac structures, measure pulmonary vein ostial dimensions, assess Doppler flow velocities, and track catheter positioning relative to venography.
- Left common pulmonary vein diameters measured larger by echocardiography than by venography (2.50 ± 0.29 cm vs. 1.79 ± 0.50 cm, P=0.001), though overall ostial diameter measurements between modalities did not correlate (r=0.23, P=0.19).
- Echocardiographic guidance resulted in replacing only 1 of 25 circular mapping catheters (4%) for incorrect sizing, while Doppler flow velocities increased in left-sided veins post-ablation without ostial diameter changes.
- The full linear electrode array was visible in only 3 of 52 catheter positions (6%) in the linear ablation cohort, with partial visualization occurring in 50% of target positions.
Structured PICO
Does phased-array intracardiac echocardiography provide utility for anatomic guidance during radiofrequency ablation for atrial fibrillation?
P
Population
29 patients undergoing pulmonary vein isolation (n = 16) or linear (n = 13) left atrial radiofrequency ablation for atrial fibrillation
I
Intervention
Real-time, phased-array intracardiac echocardiography during radiofrequency ablation
C
Comparator
Venography (for pulmonary vein ostial diameter measurement)
O
Outcome
Visualization of left atrial anatomy, pulmonary veins, and ablation/mapping catheterssurrogate
Phased-array intracardiac echocardiography is useful for guiding pulmonary vein isolation but has limited utility for visualizing linear ablation catheters in the left atrium.
Cite This Study
Martin et al. (2002) studied this question.