Key result
In non-sedated adults undergoing AF ablation, micro-TEE was significantly better tolerated than standard TEE (4.3 vs. 3.4 points, P<0.01) and scored better than ICE for assessing LA anatomy.
Why the study?
Is the use of a TEE microprobe feasible, well-tolerated, and comparable to ICE for imaging during atrial fibrillation ablation in non-sedated adults?
Observational (n=12)
Is the use of a TEE microprobe feasible, well-tolerated, and comparable to ICE for imaging during atrial fibrillation ablation in non-sedated adults?
Absolute Event Rate: 4.3% vs 3.4%
p-value: p=<0.01
Micro-TEE is a feasible, well-tolerated alternative to standard TEE and ICE for guiding transseptal puncture and assessing LA anatomy in non-sedated patients undergoing AF ablation.
Supports micro-TEE tolerability in non-sedated AF ablation; hypothesis-generating and requires randomized confirmation versus ICE.
AIMS: Imaging of the left atrium (LA) is mandatory during catheter ablation of atrial fibrillation (AF) and may be achieved by echocardiography. The aim of the present study was to assess the feasibility of using a recently released transoesophageal echocardiography (TEE) microprobe (micro-TEE) in non-sedated adult patients undergoing AF ablation and to directly compare this new technique with intracardiac echocardiography (ICE). METHODS AND RESULTS: The study group consisted of 12 consecutive patients (8 males, mean age 49 ± 14 years) who underwent first radiofrequency AF ablation. All patients underwent standard TEE, computed tomography, intraprocedural micro-TEE, and ICE. The easiness of introducing the microprobe in the supine position in non-sedated patients in the electrophysiology laboratory, its tolerability, and quality of obtained images were assessed using a five-point scale. There were no problems with microprobe introduction and obtaining images for a mean of 54 ± 17 min. The microprobe was significantly better tolerated than the standard TEE probe (4.3 ± 0.5 vs. 3.4 ± 0.6 points, P < 0.01). The micro-TEE was scored as significantly better than ICE in the assessment of the LA and LA appendage (LAA) anatomy and function. Both techniques were very useful in guiding transseptal puncture, although micro-TEE images were ranked higher by an echocardiographer than by an electrophysiologist (tenting 4.8 ± 0.6 vs. 4.0 ± 0.6 points, P < 0.01), whereas ICE images were ranked equally excellent by both observers. CONCLUSION: In non-sedated patients undergoing AF ablation, the micro-TEE can be used for the assessment of the LA, LAA, and pulmonary veins anatomy as well as the guidance of transseptal puncture.
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Stec et al. (2010) conducted an observational in Atrial fibrillation (n=12). Microprobe transoesophageal echocardiography (micro-TEE) vs. Standard TEE and intracardiac echocardiography (ICE) was evaluated on Tolerability assessed using a five-point scale (p=<0.01). In non-sedated adults undergoing AF ablation, micro-TEE was significantly better tolerated than standard TEE (4.3 vs. 3.4 points, P<0.01) and scored better than ICE for assessing LA anatomy.
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