Purpose                                                                                                                               

Catheter ablation is increasingly used to treat drug resistant atrial fibrillation (AF) and atrial tachycardias (AT). The use of intracardiac echocardiography (ICE) may help in reduction X-ray dose and complications during the procedures. We therefore analysed the duration and dose of fluoroscopy used and the incidence of complications in left atrial ablation procedures with the use of ICE in a single-center retrospective analysis and compared our results with the current literature.                       

Methods

In 223 patients with AF or AT who underwent radiofrequency ablation with the use of ICE, we investigated procedure time, fluoroscopy time and radiation dose and incidence of complications. These results were compared to 20 recent studies extracted from the literature using a similar procedural protocol but no ICE.  

Results

The median age was 66.1±9.2 years. Comorbidities included obesity (28%), arterial hypertension (69%), coronary heart disease (26%), diabetes (10%), pulmonary disease (13%), and thyroid dysfunction (13%). Mean procedure time was 154.5±41.9min. Average fluoroscopy time and radiation dose were 4.9±2.7min and 216.7±249.7cGycm², respectively. less than reported in the literature. No patient suffered cardiac tamponade. 5 (2,2%) patients had major groin complications with need for surgery or blood transfusion. In 5 (2%) patients ICE revealed thrombi in the atria during the procedure, one of these patients developed a MRI-detected cerebral stroke without sequelae.

Conclusion