Usefulness of intracardiac echocardiography during pulmonary vein isolation with the novel multipolar irrigated ablation catheter (nMARQTM)

Russo, Antonio Dello; Fassini, Gaetano; Casella, Michela; Monaco, Antonio Di; Riva, Stefania; Romanò, Valentina; Moltrasio, Massimo; Tundo, Fabrizio; Martino, Giuseppe; Majocchi, Benedetta; Marino, Vittoria; Russo, Eleonora; Pizzamiglio, Francesca; Giorno, Giuseppe Del; Pelargonio, Gemma; Biase, Luigi Di; Tondo, Claudio

doi:10.1007/s10840-015-0026-0

Cited by 6 publications

(22 citation statements)

References 19 publications

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“…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%

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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

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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.

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Section: Resultsmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 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

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“…In these studies freedom from AF rate has been reported between 61% and 83% without procedure-related complications [4], [5], [25]. Similarly, with the nMARQ ® ablation the reported ranges for the mean procedural and fluoroscopy times were 69–160 min and 2–31 min, respectively [7], [24], [26], [27]. With a single procedure, freedom from arrhythmia recurrence has been reported between 65% and 81% [11], [28], [29].…”

Section: Discussionmentioning

confidence: 88%

Pulmonary vein isolation using multi-electrode radiofrequency vs conventional point-by-point radiofrequency ablation: A meta-analysis of randomized and non-randomized studies

Aras

Topaloğlu

Çay

et al. 2017

Indian Pacing and Electrophysiology Journal

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AimsPulmonary vein isolation is effective in reducing atrial fibrillation (AF) episodes. Previous studies suggest single-shot techniques are effective and safe for this purpose. Procedural and clinical outcomes were compared between multi-electrode and point-by-point radiofrequency ablations by performing a meta-analysis of all randomized and non-randomized studies.Methods and resultsSystematic reviews of MEDLINE and Cochrane Library databases were performed. Studies comparing procedural (procedure and fluoroscopy times) and clinical (AF recurrence) outcomes were included in the meta-analysis. A total of 13 clinical studies (5 randomized and 8 non-randomized) including 2152 patients met the inclusion criteria. In patients underwent multi-electrode ablation, there were significant reductions in both total procedure and fluoroscopy times, compared with point-by-point ablation (mean difference = −34.3 min [95% CI (−50.1 to −18.5)], p < 0.001 and mean difference = −7.1 min [95% CI (−12.0 to −2.2)], p < 0.01, respectively). These significances also continued in patients with paroxysmal AF. No such difference was observed in regard to AF recurrence between the 2 ablation strategies (RR = 0.90 [95% CI (0.80–1.01)], p = 0.066). This insignificance was also observed in patients with paroxysmal AF.ConclusionsIn a heterogeneous AF population, multi-electrode ablation is as effective as point-by-point ablation, with better procedural and fluoroscopy durations.

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Intracardiac echocardiography–guided pulsed-field ablation for successful ablation of atrial fibrillation: a propensity-matched analysis from a large nationwide multicenter experience

Dello Russo,

Tondo,

Schillaci

et al. 2023

J Interv Card Electrophysiol

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Usefulness of intracardiac echocardiography during pulmonary vein isolation with the novel multipolar irrigated ablation catheter (nMARQTM)

Abstract: ICE might be a useful tool to guide nMARQ(TM) catheter position in the left atrium during atrial fibrillation (AF) ablation procedures.

Cited by 6 publications

References 19 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

Pulmonary vein isolation using multi-electrode radiofrequency vs conventional point-by-point radiofrequency ablation: A meta-analysis of randomized and non-randomized studies

Intracardiac echocardiography–guided pulsed-field ablation for successful ablation of atrial fibrillation: a propensity-matched analysis from a large nationwide multicenter experience

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