Clinical outcomes of radiofrequency catheter ablation guided by intracardiac echocardiography for Chinese atrial fibrillation patients: a single-center, retrospective study

Dongchen Zhou; Jian Yang; Biqi Zhang; Jie Han; Chenyu Zuo; Xingwei Lu; Jianwei Xuan; Xiaogang Guo

doi:10.21037/jtd-23-1418

Clinical outcomes of radiofrequency catheter ablation guided by intracardiac echocardiography for Chinese atrial fibrillation patients: a single-center, retrospective study

J Thorac Dis. 2024 Apr 30;16(4):2341-2352. doi: 10.21037/jtd-23-1418. Epub 2024 Apr 28.

Authors

Dongchen Zhou¹, Jian Yang¹, Biqi Zhang¹, Jie Han¹, Chenyu Zuo², Xingwei Lu², Jianwei Xuan³, Xiaogang Guo¹

Affiliations

¹ Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
² Shanghai Centennial Scientific Co., Ltd., Shanghai, China.
³ Health Economic Research Institute, School of Pharmacy, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Intracardiac echocardiography (ICE) is a novel technology with certain advantages in treatment of atrial fibrillation (AF), yet there is limited research on the use of ICE in radiofrequency ablation for AF treatment in China. The aim of this study was to investigate the total fluoroscopy time and dose, safety, and effectiveness of ICE guided vs. traditional fluoroscopy (non-ICE) guided radiofrequency ablation for AF in China.

Methods: We conducted a single-center retrospective analysis of patients who underwent ICE or traditional fluoroscopy-guided radiofrequency ablation for AF. The primary endpoint of this study was total fluoroscopy time, and the secondary endpoints included total fluoroscopy dose, acute surgery failure, transseptal puncture time, ablation time, total procedure time, and 6-month surgery success (no AF recurrence or atrial flutter). As an exploratory analysis, outcomes of interest by different types of AF were examined.

Results: A total of 97 patients were included in the analysis. Forty-eight were in the ICE group and 49 were in the non-ICE group with comparable demographic and clinical characteristics at the baseline. None of patients experienced acute surgery failure with no major procedure-related complications occurred. The fluoroscopic time and dose were significantly lower in the ICE group compared to the non-ICE group (0.00 vs. 9.67±4.88 min, P<0.001; 0.00 vs. 77.10±44.28 mGy/cm², P<0.001, respectively). There were no statistically significant differences in transseptal puncture time, ablation time and total procedure time between the two groups. There were two AF recurrences observed during the 6-month follow-up in each group (P>0.99).

Conclusions: ICE significantly reduced the fluoroscopic time and dose for radiofrequency catheter ablation in AF patients. There were no significant differences in safety or effectiveness outcomes between the ICE and non-ICE groups.

Keywords: Intracardiac echocardiography (ICE); atrial fibrillation (AF); radiation exposure; zero-fluoroscopy ablation.