Why the study?
Does continuous transesophageal echocardiography monitoring improve procedural guidance during pulmonary vein cryoballoon ablation for atrial fibrillation?
Does continuous transesophageal echocardiography monitoring improve procedural guidance during pulmonary vein cryoballoon ablation for atrial fibrillation?
Transesophageal echocardiography provides effective continuous procedural monitoring and guidance during pulmonary vein cryoballoon ablation for atrial fibrillation.
May support TEE monitoring in cryoballoon ablation; hypothesis-generating and requires randomized confirmation before practice change.
We describe our first 20 cases of cryoablation of atrial fibrillation (AF) using transesophageal echocardiography (TEE). Continuous procedural monitoring with TEE by a cardiologist and senior sonographer assists the electrophysiologist in performance of the cryoballoon procedure of AF. Previously using intracardiac echocardiography (ICE) we have found TEE to have better overall procedural imaging, and monitoring for pericardial effusion or thrombus formation. We have found TEE monitoring to be helpful with positioning for interatrial septal (IAS) puncture, catheter tip avoidance of the left atrial appendage (LAA), and guidance of the balloon catheter into each pulmonary vein (PV), with proper positioning within each PV orifice, and documentation of PV occlusion for the cryoballoon procedure. Procedural equipment and the cryoballoon protocol used are presented in detail. The role of TEE imaging during the procedure and in preventing potential dangers is illustrated. It is the goal of this study to demonstrate how the electrophysiology and echocardiography laboratories work together in this cryoablation procedure.
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Kerut et al. (2014) studied this question.
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