Outcomes Of Intracardiac Echocardiography Catheter Assisted Radiofrequency Ablation Of Atrial Fibrillation With Contrast Media Incompatible Patients

Objectives:To investigate the safety and clinical efficacy of transcatheter radiofrequency ablation in the treatment of atrial fibrillation with contrast media incompatibility in patients with intracardiac echocardiography.Methods:16 patients admitted to Fuwai hospital,Chinese Academy of Medical Science,with atrial fibrillation and contrast incompatibility were selected from January 2015 to January 2017.No left atrial and pulmonary vein CT and angiography were performed.Three-dimensional model of left atrium and pulmonary vein was established with intracardiac echocardiography,and guided operation of the interatrial septum puncture and the ablation catheter in the heart.Results:Among them,15 patients successfully completed radiofrequency ablation,the average operation time was 96.0±14.3 min,the average fluoroscopy time was 6.1±1.2 min,and the average X-ray fluoroscopy dose was 115.8±49.3 mGy.There were no complications such as cardiac tamponade,cerebral embolism,left atrial esophageal fistula,pulmonary vein stenosis,aneurysm and death.One-year follow-up results showed that 9 patients maintained sinus rhythm,including 7 patients with paroxysmal atrial fibrillation and 2 patients with persistent atrial fibrillation.Conclusions:For patients with atrial fibrillation and contrast media incompatibility,Intracardiac Echocardiography can not only cover the role of transesophageal echocardiography but also eliminate left atrial angiography and enhanced CT angiography;It does not prolong operation time,and reduce the X-ray exposure time and dose significantly.What’s more,it can also avoid the complications of interatrial septum puncture.