Key result
EAM plus 3D ICE reconstruction enables fluoroscopy-free transseptal access after PFO closure during AF ablation.
Why the study?
Although contemporary dose-reduction protocols have reduced radiation exposure during AF ablation, ionizing radiation from fluoroscopy-guided transseptal access remains cumulative for both patients and electrophysiology laboratory personnel.
Case Report
Demonstrates the feasibility of combining electroanatomic mapping and 3D intracardiac echocardiography to achieve fluoroscopy-free transseptal puncture during atrial fibrillation ablation after patent foramen ovale closure.
Answers are grounded in this paper and cite their sources.
May allow fluoroscopy-free transseptal access post-PFO closure in AF ablation; leaves open reproducibility beyond single cases.
Fluoroscopy has traditionally been used to guide catheter positioning and transseptal access during atrial fibrillation (AF) ablation. Although contemporary dose-reduction protocols have markedly reduced radiation exposure, ionizing radiation remains cumulative for both patients and electrophysiology laboratory personnel.1 The combination of electroanatomic mapping and intracardiac echocardiography (ICE) has enabled AF ablation, including transseptal puncture, to be performed without fluoroscopy.
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Vetta et al. (2026) conducted a case report in Atrial fibrillation with prior patent foramen ovale closure. Fluoroscopy-free transseptal access guided by three-dimensional intracardiac echocardiographic (ICE) reconstruction and electroanatomic mapping was evaluated on Successful fluoroscopy-free transseptal access. Electroanatomic mapping combined with 3D intracardiac echocardiographic reconstruction enables fluoroscopy-free transseptal access after patent foramen ovale closure during AF ablation.
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