What question did this study set out to answer?

To prospectively compare intracardiac echocardiography (ICE) against standard fluoroscopic guidance for creating radiofrequency linear atrial lesions.

October 27, 1998Circulation

Comparative Study of Fluoroscopy and Intracardiac Echocardiographic Guidance for the Creation of Linear Atrial Lesions

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Why the study?

Does intracardiac echocardiography (ICE) guidance improve the creation of linear atrial lesions compared to fluoroscopy alone in a canine model?

Population

10 dogs (canine model)

Comparison

Intracardiac echocardiography guidance for the… vs Fluoroscopy guidance alone (ICE-blinded)

Design

Preclinical, ICE-blinded for the fluoroscopy alone group

Authors

LELaurence M. EpsteinElectrophysiology MMMark A. MitchellLouisiana State University TSTimothy W. SmithBrigham Young University

Discussion

Member takes

Implication

ICE guidance enhanced lesion parameters in canines; leaves open clinical benefit and safety in human atrial ablation.

Key Points

To prospectively compare intracardiac echocardiography (ICE) against standard fluoroscopic guidance for creating radiofrequency linear atrial lesions.
Prospective experimental study in 10 canine models undergoing 3 attempted linear atrial radiofrequency lesions guided by either fluoroscopy alone (n=5) or ICE (n=5).
Evaluated coil-tissue contact scores, application success, heating efficiency, operator localization discrepancy, and post-euthanasia pathological lesion continuity.
ICE guidance produced a significantly higher rate of successful applications (P=0.02) and higher mean achieved temperatures (P=0.004) compared with fluoroscopy.
Electrode-tissue contact scores strongly correlated with successful energy delivery, mean temperature, and heating efficiency (P<0.0001).
Operator-perceived catheter location differed from actual ICE location in 25% of blinded deliveries, resulting in off-target lesions in the fluoroscopy group that were completely absent with ICE guidance.

Structured PICO

Does intracardiac echocardiography (ICE) guidance improve the creation of linear atrial lesions compared to fluoroscopy alone in a canine model?

Population

10 dogs (canine model)

Intervention

Intracardiac echocardiography (ICE) guidance for the creation of linear atrial lesions with radiofrequency energy

Comparator

Fluoroscopy guidance alone (ICE-blinded)

Outcome

Percentage of successful applications, mean achieved temperature, and pathological evaluation of lesion location and continuitysurrogate

In a canine model, ICE guidance improved targeting, energy delivery, and lesion formation for linear atrial ablation compared to fluoroscopy alone.

Cite This Study

Epstein et al. (1998) studied this question.

synapsesocial.com/papers/6a759988f1e99ff85ab1fe15 https://doi.org/10.1161/01.cir.98.17.1796

Topics

Atrial fibrillation Echocardiography Persistent AF management AF ablation outcomes

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Comparative Study of Fluoroscopy and Intracardiac Echocardiographic Guidance for the Creation of Linear Atrial Lesions

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Comparative Study of Fluoroscopy and Intracardiac Echocardiographic Guidance for the Creation of Linear Atrial Lesions

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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