Study on the Curative Effect and Safety of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation via Zero-Fluoroscopy Transseptal Puncture under the Dual Guidance of Electroanatomical Mapping and Intracardiac Echocardiography

Hang, Fei; Cheng, Liao‐Ping; Liang, Zhuo; Dong, Ruijuan; Wang, Xinlu; Wang, Ziyu; Wang, Zefeng; Wu, Yongquan

doi:10.1155/2021/5561574

Cited by 7 publications

(5 citation statements)

References 12 publications

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“…Can the mapping and ablation that guided by ICE improve the success rate of ablation? Fei et al concluded through the follow-up of 110 patients with PAF receiving ablation that ICE has no advantage in effectiveness [4]. Our study showed that the ablation success rate in ICE group was higher than that in control group, but there was no signi cant difference.…”

Section: Discussioncontrasting

confidence: 51%

Application of intracardiac echocardiography in the radiofrequency ablation of atrial fibrillation

Feng

Sun

lin

et al. 2022

Preprint

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Background Intracardiac echocardiography (ICE) has been used in the radiofrequency ablation of arrhythmia since 1994. This study investigated the efficacy and safety of ICE assiting the ablation of atrial fibrillation.Methods From May 2020 to February 2021, 100 patients with atrial fibrillation underwent radiofrequency ablation assisted by ICE and three-dimensional mapping system. They were enrolled in ICE group. In the same period, 100 patients with atrial fibrillation who only received radiofrequency ablation assisted by three-dimensional mapping system were enrolled in control group. The patients were followed up and the fluoroscopy times, complications and success rates were compared. Results 1. The X-ray fluoroscopy times in ICE group was significantly shorter than that in control group. In ICE group there was no pericardial tamponade during atrial septal puncture. But in control group there were three cases of pericardial tamponade during atrial septal puncture; 2. The injury of vagus nerve around esophagus in ICE group was significantly less than that in control group; 3. There was no significant difference in the success rate between the two groups. Conclusions ICE can significantly increase the safety of the radiofrequency ablation of atrial fibrillation.

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Section: Discussioncontrasting

confidence: 51%

Application of intracardiac echocardiography in the radiofrequency ablation of atrial fibrillation

Feng

Sun

lin

et al. 2022

Preprint

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“…In addition, the formation of microbubbles, visible with ICE, may be a frequent indication of excessive heating of the tissues during radiofrequency delivery and, finally, to select in certain cases the site of puncture of the oval fossa in relation to the type of procedure, with the possible benefit of the maneuverability of catheters [ 17 ]. Finally, the integration of the ICE with electroanatomical mapping systems has also proved very promising in the drastic reduction in scan times during TSC [ 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory

Bottoni

Donateo²,

Rossi

et al. 2023

JCDD

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Aims: To explore the impact of the use of intracardiac echocardiography (ICE) in the ablation of supraventricular arrhythmias requiring transseptal catheterization (TSC), whilst analyzing the reduction in periprocedural complications and complications specifically related to TSC. Methods: A retrospective multicenter study collecting data from consecutive atrial fibrillation (AF) and supraventricular ablation procedures that required TSC was performed in five Italian centers. Based on physician discretion, TSC was performed with or without ICE. Periprocedural complications, separating all complications from complications directly related to TSC, were collected. Independent predictors of periprocedural complications and TSC-related complications were investigated. Results: A total of 2181 TSCs were performed on 1862 patients at five Italian centers from 2006 to 2021, in 76% of cases by AF ablation and in 24% by ablation of other arrhythmias with a circuit in the left atrium. Overall, 1134 (52%) procedures were performed with ICE support and 1047 (48%) without ICE. A total of 67 (3.1%) complications were detected, 19 (1.7%) in the ICE group and 48 (4.6%) in the no ICE group, p < 0.001. A total of 42 (1.5%) complications directly related to TSC: 0.9% in the ICE group and 3.1% in the no ICE group (p < 0.001). The independent predictors of all complications were age (OR 1,02 95% C.I 1.00–1.05; p = 0.036), TSC with the use of ICE (OR 0.27 95% C.I 0.15–0.46; p < 0.001) and AF ablation (OR 2,25 95%C.I 1.05–4.83; p = 0.037). The independent predictors for TSC complications were age (OR 1.03 95% C.I 1.01–1.06; p = 0.013) and TSC with the use of ICE (OR 0.24 95% C.I 0.11–0.49; p < 0.001). Conclusions: ICE reduced periprocedural and TSC-related complications during electrophysiological procedures for ablation of left atrial arrhythmias.

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“…Zero/minimized fluoroscopy AF ablation has been performed safely in many electrophysiology labs. 8,9 We proposed that ICE could provide direct visual guidance to further improve safety when using an electrocautery assisted J-wire TSP technique, especially during the process of delivering energy and initially crossing the septum. We designed this prospective randomized study to testify the safety and efficacy of using an electrified J-wire for ICE-guided zero-fluoroscopy TSP.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the use of intracardiac echocardiography (ICE) during AF catheter ablation or other interventional cardiac procedures has become more prevalent. Zero/minimized fluoroscopy AF ablation has been performed safely in many electrophysiology labs 8,9 . We proposed that ICE could provide direct visual guidance to further improve safety when using an electrocautery assisted J‐wire TSP technique, especially during the process of delivering energy and initially crossing the septum.…”

Section: Introductionmentioning

confidence: 99%

Intracardiac echocardiography guided electrified J‐wire trans‐septal puncture: A prospective randomized controlled trial

Cheng,

Bangash,

Tao

et al. 2024

Pacing Clinical Electrophis

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BackgroundApplication of electrocautery to a J‐wire is used to perform transseptal puncture (TSP), but with limited evidence supporting safety and efficacy. We conducted a prospective randomized controlled trial to evaluate the safety and efficacy of this technique.MethodsTwo hundred consecutive patients were randomized in a 1:1 fashion to either the ICE‐guided electrified J‐wire TSP group or a conventional Brockenbrough (BRK) needle TSP group. The TSP was performed with a 0.032″ guidewire under 20 W, “coag” mode and was compared to TSP using the BRK needle. The primary safety endpoints were complications related to TSP. The primary efficacy endpoints included the TSP success rate, the total TSP time, and the total procedure time.ResultsAll patients complete the procedure safely. The electrified J‐wire TSP group had a significantly shorter TSP time than BRK needle TSP group. The total procedure time, number of TSP attempts required to achieve successful LA access, width of the intra‐atrial shunt at the end of ablation were similar between the two groups. The incidence of new cerebral infarction detected by MRI were similar between the two groups (3/32 patients in the J‐wire TSP group and 2/26 patients in conventional BRK TSP group, p = .82). And no difference in the incidence of residual intra‐atrial shunt (4.3% vs. 6%, p = .654) during the 3‐month's follow up.ConclusionUsing an electrified J‐wire for TSP under the guidance of ICE appears to be as safe as and more efficient than conventional BRK needle TSP, which may be especially useful in the era of non‐fluoroscopy AF ablation.

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Study on the Curative Effect and Safety of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation via Zero-Fluoroscopy Transseptal Puncture under the Dual Guidance of Electroanatomical Mapping and Intracardiac Echocardiography

Cited by 7 publications

References 12 publications

Application of intracardiac echocardiography in the radiofrequency ablation of atrial fibrillation

Application of intracardiac echocardiography in the radiofrequency ablation of atrial fibrillation

Impact of Systematic Use of Intracardiac Ultrasound during Transseptal Catheterization in the Electrophysiology Laboratory

Intracardiac echocardiography guided electrified J‐wire trans‐septal puncture: A prospective randomized controlled trial

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