Efficacy and safety of intracardiac echocardiography-guided radiofrequency ablation for atrial fibrillation: a retrospective report of 192 cases

Abstract

Objective To investigate the efficacy and safety of catheter ablation for atrial fibrillation under the guidance of intracardiac echocardiography (ICE). Methods A retrospective cohort trial was conducted on all the patients who underwent radiofrequency catheter ablation due to atrial fibrillation in our department from February 2019 to July 2020. They were divided into ICE group (n=192) and non-ICE group (n=167). The radiation exposure time, radiation exposure amount, total ablation time, single coil isolation rate, and incidence of complications were compared between the 2 groups to evaluate the efficacy and safety of ICE-guided ablation for atrial fibrillation. Results The ICE group had significantly shorter total ablation time (68.35±1.09 vs 74.37±1.69 min, P < 0.01), higher single coil isolation rate (70.83% vs 53.89%, P < 0.01), less radiation exposure amount (33.86±1.51 vs 212.30±21.11 mGy, P < 0.01) and shorter radiation time (4.90±0.23 vs 13.51±0.34 min, P < 0.01) when compared with the non-ICE group. No statistical difference was seen in the incidence of complications between the 2 groups. Complications were observed in 2 cases of both groups. There were no serious complication in the ICE group, while 1 case of intraoperative cardiac perforation was in non-ICE group. Though no significant difference was found in the early and late recurrence rates of ablation in the ICE group than the non-ICE group, a decreasing trend in late recurrence rates was observed in both groups (3.13% vs 7.78%, P=0.06). Conclusion ICE-guided catheter ablation of atrial fibrillation has higher ablation efficiency and less radiation exposure. There is no significant difference in safety between the 2 groups, but ICE leads to a decreasing trend in late recurrence rate.

Keywords

• atrial fibrillation
• catheter ablation
• intracardiac echocardiography