Abstract | BACKGROUND: OBJECTIVE: The purpose of this study was to evaluate the feasibility and safety of pulmonary vein (PV) isolation with zero fluoroscopy use, using a combination of three-dimensional EAM and intracardiac echocardiography ( ICE). METHODS: Using the NavX EAM system, the right atrial (RA) and coronary sinus (CS) geometries were created without fluoroscopy. Fluoroless transseptal puncture was performed under ICE guidance. Using a deflectable sheath and a multipolar catheter, the left atrial (LA) and PV anatomies were rendered and, in select cases, integrated with a three-dimensional computed tomography (CT) image. Irrigated radiofrequency ablation was performed to encircle each pair of ipsilateral PVs. RESULTS: This series included 20 consecutive PAF patients. RA/CS mapping required 5.5 ± 2.6 minutes. In all patients, single (n = 18) or dual (n = 2) transseptal access was successfully achieved. The LA-PV anatomy was rendered using either a circular (14 patients) or penta-array (six patients) catheter in 22 ± 10 minutes; CT image integration was used in 11 patients. Using 49 ± 18 ablation lesions/patient, electrical isolation was achieved in 38/39 ipsilateral PV isolating lesion sets (97%). The procedure time was 244 ± 75 minutes. There were no complications. CONCLUSION: Completely fluoroless catheter ablation of paroxysmal AF is safely feasible using a combination of ICE and EAM.
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Authors | Vivek Y Reddy, Gustavo Morales, Humera Ahmed, Petr Neuzil, Srinivas Dukkipati, Steve Kim, Janet Clemens, Andre D'Avila |
Journal | Heart rhythm
(Heart Rhythm)
Vol. 7
Issue 11
Pg. 1644-53
(Nov 2010)
ISSN: 1556-3871 [Electronic] United States |
PMID | 20637313
(Publication Type: Clinical Trial, Journal Article)
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Copyright | Copyright © 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Aged
- Atrial Fibrillation
(surgery)
- Body Surface Potential Mapping
- Catheter Ablation
- Feasibility Studies
- Female
- Fluoroscopy
- Humans
- Male
- Middle Aged
- Pulmonary Veins
(surgery)
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