Transesophageal echocardiography to guide pulmonary vein mapping and ablation for atrial fibrillation

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Tim D KinnairdJohn A Yeung-Lai-Wah

Abstract

This study describes the use and outcomes of transesophageal echocardiography to guide atrial fibrillation (AF) ablation procedures. Under general anesthesia, 25 patients with a history of AF underwent multiplane transesophageal echocardiography in conjunction with catheter placement under fluoroscopy. In this series, a combined fluoroscopic/echocardiographic approach obviated the need for angiographic imaging. Anatomic variation in pulmonary veins (PV) was common; the shortest distance between the ostia ranged from 2 to 11 mm. Individual PV diameters did not predict the presence of ectopic foci. The number of radiofrequency pulses delivered per vein was 2.6 +/- 2.3 (range: 0-10). Mean fluoroscopy time per procedure was 31 +/- 13 minutes and mean procedure time was 110 +/- 31 minutes. At follow-up, 68% of patients were free from AF. Transesophageal echocardiography enables identification and cannulation of the ostia and proximal branches of PV during AF ablation. Fluoroscopy, procedure times, and outcomes compare favorably with series using PV angiography and, as such, suggest that a controlled trial is warranted.

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Citations

Dec 6, 2012·Herzschrittmachertherapie & Elektrophysiologie·Klaus-Jürgen GutlebenJens Günther
Aug 7, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Bruce Lloyd CartwrightJeremy Cooper
Sep 13, 2006·Ultrasound in Medicine & Biology·Mark HastenteufelIvo Wolf
May 13, 2014·Echocardiography·Edmund Kenneth KerutJames McKinnie
Nov 23, 2006·Journal of the American College of Cardiology·Oussama M WazniAllan L Klein
Oct 10, 2012·International Journal of Cardiology·Michaël PeyrolFranck Paganelli
Feb 17, 2007·Pacing and Clinical Electrophysiology : PACE·Jean ChampagneGilles O'hara
May 24, 2007·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Mark HastenteufelIvo Wolf
Apr 22, 2006·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Wojciech KosmalaWalentyna Mazurek
Feb 16, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Takashi NakashimaShinya Minatoguchi

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