Routine use of intracardiac echocardiography for atrial flutter ablation is associated with reduced fluoroscopy time, but not with a reduction of radiofrequency energy delivery time

Heřman, Dalibor; Osmančík, Pavel; Zdarska, Jana; Procházková, Radka

doi:10.4022/jafib.1553

Cited by 10 publications

(25 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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).…”

Section: Resultsmentioning

confidence: 78%

“…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).…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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).…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies were included in the analysis, 10,22,25–28,31–36,38 11 of which reported 100% acute success in one or both arms 10,22,25–28,31,33–36 . Therefore, there was little heterogeneity among studies (I 2 = 30%).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

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

Goya

Frame

Gache

et al. 2020

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Aims The optimal use of intracardiac echocardiography (ICE) may reduce fluoroscopy time and procedural complications during endocardial ablation of cardiac arrhythmias. Due to limited evidence in this area, we conducted the first systematic literature review and meta‐analysis to evaluate outcomes associated with the use of ICE. Methods and Results Studies reporting the use of ICE during ablation procedures vs without ICE were searched using PubMed/MEDLINE. A meta‐analysis was performed on the 19 studies (2186 patients) meeting inclusion criteria, collectively representing a broad range of arrhythmia mechanisms. Use of ICE was associated with significant reductions in fluoroscopy time (Hedges' g −1.06; 95% confidence interval [CI] −1.81 to −0.32; P < .01), fluoroscopy dose (Hedges' g −1.27; 95% CI −1.91 to −0.62; P < .01), and procedure time (Hedges' g −0.35; 95% CI −0.64 to −0.05; P = .02) vs ablation without ICE. A 6.95 minute reduction in fluoroscopy time and a 15.2 minute reduction in procedure time was observed between the ICE vs non‐ICE groups. These efficiency gains were not associated with any decreased effectiveness or safety. Sensitivity analyses limiting studies to an atrial fibrillation (AF) only population yielded similar results to the main analysis. Conclusion The use of ICE in the ablation of cardiac arrhythmias is associated with significantly lower fluoroscopy time, fluoroscopy dose, and shorter procedure time vs ablation without ICE. These efficiency improvements did not compromise the clinical effectiveness or safety of the procedure.

show abstract

Section: Resultsmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Goya

Frame

Gache

et al. 2020

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

The Advanced Application of Intracardiac Echocardiography for Cardiac Electrophysiology Ablation Procedures

et al. 2022

View full text Add to dashboard Cite

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Kwon

Lee

Park

et al. 2020

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Despite many studies on new tools and strategies for cavotricuspid isthmus (CTI) ablation, there is an unmet need to improve the CTI ablation procedure. Recently, high‐power short‐duration (HPSD) ablation has been widely used for pulmonary vein (PV) isolation in atrial fibrillation. We evaluated the effectiveness and safety of HPSD for CTI ablation in atrial flutter (AFL). Methods Eighty‐four patients who underwent CTI ablation with or without simultaneous PV isolation between January 2018 and February 2019 were enrolled in this prospective cohort study. We compared procedural characteristics, periprocedural complications, and recurrence of atrial tachyarrhythmia (ATa) between the HPSD group (50 W for 15 s) and conventional group (30 W for 60 s). Results A total of 84 patients were divided into the HPSD (n = 42) and conventional (n = 42) groups. Bidirectional CTI block was achieved in all patients and 95% achieved bidirectional block after the first‐line ablation in both groups. Although there was no difference in the total number of ablation lines between the two groups (1.17 ± 0.7 vs 1.38 ± 0.8, P = .067), HPSD ablation significantly reduced total ablation time compared to the conventional group (236.0 ± 85.6 vs 534.2 ± 235.2 s, P < .001). One pericardial tamponade was reported in the HPSD group. During the mean follow‐up of 9.3 ± 4.8 months, CTI‐dependent AFL recurrence occurred in one patient in the HPSD group. Recurrence of ATa developed in 14 patients with no significant difference between the groups. Conclusion Our study demonstrates that HPSD CTI ablation is safe and can shorten procedure time.

show abstract

Routine use of intracardiac echocardiography for atrial flutter ablation is associated with reduced fluoroscopy time, but not with a reduction of radiofrequency energy delivery time

Abstract: The use of ICE for atrial flutter ablation is associated with less fluoroscopy time and improved ability to achieve bidirectional block compared to traditional conventional flutter ablation methods. However, it is not asoociated with reduced ablation time or overall procedure duration.

Cited by 10 publications

References 12 publications

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

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

The Advanced Application of Intracardiac Echocardiography for Cardiac Electrophysiology Ablation Procedures

Effectiveness and safety of high‐power and short‐duration ablation for cavotricuspid isthmus ablation in atrial flutter

Contact Info

Product

Resources

About