Introduction: Intracardiac Echo (ICE) is relatively new imaging method and it is not widespread currently, especially in Russia.
Materials and Methods: We analyzed the results of 44 AF-ablation procedures with Intracardiac Echo (ICE) convoy (1st group), and compared them with 35 control patients without ICE (2nd group). 32 AFlut-procedures (3rd group), and compared them with 20 patients (4th group). 10 F AcuNav sensors (Siemens) together with Vivid q ultrasound machine (GE), closed and open irrigated ablation catheters (Boston Scientific) have been used.
Results: The average fluoroscopy time in 1st group was 36±12 min, and 57±16 min in 2nd one. We observed 4 complicated cases in patients without ICE: puncture of the aorta, which required surgery; penetration of contrast into the pericardium cavity during transseptal puncture; and 2 hemopericardiums. The ICE group we observed 1 hemopericardium after pumping during left veins isolation. We successfully completed the procedure using ICE. Also we observed phenomenon of silent pumping and several complicated cases of transseptal puncture. In one case we utilized ICE to evaluate LAA in patient with the diverticulum of the esophagus directly before the procedure.
In total AFlut we significantly reduced a fluoroscopy time, up to fully ICE-guided ablation in 5 patients.
Conclusions: ICE allows to perform transseptal puncture safely and to monitor complications, especially for those starting practicing AF-ablation; helps to reduce time of fluoroscopy significantly and to navigate inside the left atrium, as well as to evaluate contact of ablating catheter with left atrial wall; ICE is indispensable instrument in cases of impossibility of TEE using; in AFlut ablation ICE helps rapidly to achieve isthmus-block especially in cases with complicated anatomy, and almost to exclude a fluoroscopy time; ICE does not require a specialist and is more convenient for both a surgeon and a patient.