Key result
Using a visualizable steerable sheath for pulmonary vein isolation significantly reduced total fluoroscopy time compared to a standard sheath (197 vs. 267 seconds; p=0.03).
Why the study?
A new steerable sheath visualizable by electroanatomical mapping systems became available, prompting comparison with non-visualizable sheaths during pulmonary vein isolation for atrial fibrillation.
Does a visualizable steerable sheath reduce fluoroscopy exposure and procedure time compared to a standard non-visualizable sheath in patients undergoing PVI for AF?
RCT (n=58)
randomized
No
Does a visualizable steerable sheath reduce fluoroscopy exposure and procedure time compared to a standard non-visualizable sheath in patients undergoing PVI for AF?
The use of a visualizable steerable sheath during PVI for atrial fibrillation significantly reduces fluoroscopy time and dose, as well as left atrial procedure time, without increasing complications.
Visualizable steerable sheaths shorten LA procedure time, ablation time, and fluoroscopy in PVI; supports their preference over standard sheaths in AF ablation.
Funding Acknowledgements Type of funding sources: None. Background/Introduction Steerable sheaths are frequently used to improve catheter contact during pulmonary vein isolation (PVI) procedures. A new type of visualized (by electroanatomical mapping system) steerable sheath has become available in clinical treatment. Purpose We aimed to compare procedural data of visualizable vs. non-visualizable steerable sheath assisted PVI procedures of patients with atrial fibrillation (AF). Methods In this single-center randomized study, we enrolled a total of 58 consecutive patients who underwent PVI due to AF. In 30 patients, the procedures were performed using non-visualizable steerable sheath (Group 1), while we used visualizable steerable sheath for PVI in 28 cases (Group 2). Results Compared to Group 1, using the visualizable sheath significantly reduced total fluoroscopy time (267 ± 145 s vs. 197 ± 74 s; p=0.03), fluoroscopy dose (26.2 ± 24.7 mGy vs. 16.7 ± 16.1 mGy; p=0.04) and left atrial procedure time (72.1 ± 18.7 min vs. 61.4 ± 18.9 min; p=0.05). Total ablation time (1158 ± 347 s vs. 1067 ± 196 s; p= 0.28), number of radiofrequency pulses (78 ± 19 vs. 77 ± 32; p=0.81) and total procedure time (117.7 ± 30.0 min vs. 105.0 ± 21.4 min; 0.09) did not differ between the two groups. No major complications occurred in either group. Conclusion Using visualizable steerable sheath for PVI procedures can reduce fluoroscopy exposure and left atrial procedure time compared to standard, non-visualizable steerable sheath in patients undergoing PVI procedures.
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Janosi et al. (2022) conducted an RCT in atrial fibrillation (AF) (n=58). Visualizable steerable sheath vs. Standard, non-visualizable steerable sheath was evaluated on Total fluoroscopy time (seconds) (p=0.03). Using a visualizable steerable sheath for pulmonary vein isolation significantly reduced total fluoroscopy time compared to a standard sheath (197 vs. 267 seconds; p=0.03).
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