ICE guidance for AF catheter ablation: beginning of a new era?

Objective: To show whether the use of ICE reduces radiation exposure in AF patients undergoing radio-frequency catheter ablation.

Methods: 78 patients that undergone radiofrequency catheter ablation for AF in our center between 1st of January 2018 and 1st of June 2019 were included. After the application of exclusion criteria, 52 patients were selected of which 40 patients with paroxysmal atrial fi-brillation and 12 with persistent atrial fibrillation. They were divided in two groups: Group 1 – 26 patients in which the procedure was performed under ICE gui-dance and Group 2 – 26 patients in which ablation was performed without using ICE. Total ablation time and fluoroscopy dose and time were compared between the two groups. The total ablation time was defined as the time from the groin puncture until the withdrawal of all catheters.

Results: Among the 52 patients included, 33 were men (71.7%) and the mean age was 59 years old. We found that the mean procedure time was similar between the two groups (181.54 ± 50.3 for group 1 and 197.31 ± 49.8 for group 2, p=0.348). Nevertheless, in both groups the use of ICE was associated with lower fluoroscopy dose (11839.60 ± 6100.6 vs. 16260.43 ± 8264.5, p=0.041) and time (28.00 ± 12.5 vs. 42.93 ± 12.7, p=0.001). These re-sults were similar for both patients with paroxysmal or persistent atrial fibrillation.

Conclusions: Atrial fibrillation catheter ablation using ICE guidance reduces radiation exposure by lowering the fluoroscopy dose and the time of exposure but does not reduce overall procedure duration.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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