Nonfluoroscopic catheter ablation of paroxysmal atrial fibrillation

Abstract

Nonfluoroscopic ICE-guided catheter ablation of AF without prior cardiac image integration or angiography is feasible and safe. PVI without fluoroscopy did not affect procedure duration or long-term efficacy.

The use of intracardiac echocardiography catheters in endocardial ablation of cardiac arrhythmia: Meta‐analysis of efficiency, effectiveness, and safety outcomes

“…The significant reduction in fluoroscopy time demonstrated in the main analysis was robust in all sensitivity testing, including studies with only AF patients (Hedges' g −1.25; 95% CI −2.14 to −0.36; P < .01) 10,11,24,26–31,37,38 . (Table S3).…”

“…Ten studies reported fluoroscopy dose data, with significant heterogeneity among studies (I 2 = 93%) and no evidence of publication bias or small study effects 23–28,31,33,37,38 . Use of ICE in ablation procedures showed significant reductions in fluoroscopy dose vs ablation without the use of ICE (Hedges' g −1.27; 95% CI −1.91 to −0.62; P < .01) (Figure 3A).…”

“…Nineteen studies with a total sample size of 2186 patients were included in the main analysis, encompassing patients with any form of atrial or ventricular arrhythmia undergoing catheter ablation (see Table S2 for individual study details) 10,22–38 . The characteristics of the included studies are summarized in Table 1.…”

“…(Table S3). In addition, analyses that removed an outlying and influential study ( P < .01), 31 included studies with imputed means and/or SD values ( P < .01), 32,34,36 used an alternate group for 3‐arm studies ( P = .04), 10,11,29 used the HKSJ method ( P < .01), or used only sensor‐based ICE catheters ( P = .02), 10,24,35 all remained statistically significant. For sensor‐based ICE catheters, mean difference analysis demonstrated a 12.74 minute reduction in fluoroscopy time.…”

“…Data for procedure time were available from 14 studies, with significant heterogeneity among studies (I 2 = 86%) and no evidence of publication bias or small study effects 10,11,24–31,33,35,37,38 . A significant decrease in procedure time was associated with ablation procedures using ICE vs those without (Hedges' g −0.35; 95% CI −0.64 to −0.05; P = .02) (Figure 3B).…”