Abstract
Introduction: Radiofrequency catheter ablation (RFA) for atrial fibrillation (AF) is being increasingly performed without fluoroscopy. There is limited experience in flouroless RFA for AF in patients with pre-existing cardiac implantable electronic devices (CIED). Hypothesis: The safety of Fluoroless RFA for AF in patients with pre-existing CIED is uncertain. Methods: In this single-center study, we retrospectively evaluated patients undergoing fluoroless RFA for AF with pre-existing CIED in situ. A total of two hundred and sixty-four (264) consecutive fluoroless RFA procedures for AF from 6/1/2019 to 5/2/2022 were evaluated. All procedures were performed with intracardiac echocardiography (ICE) support. We assessed rates of CIED-related complications and changes in lead parameters over 30 days of follow-up. Pre and post-ablation device interrogations were reviewed for interval changes and compared for any change in the device or lead parameters. Patients were tracked for any subsequent device malfunction. Results: Among 264 fluoroless AF ablations patients, 25 (9.5%) had pre-existing CIED (13 dual-chamber pacemakers, 4 dual-chamber defibrillators, 4 single-chamber defibrillators/pacemakers, and 4 biventricular devices). Mean age was 71.2 ± 6.0 years with mean duration of indwelling CIED was 1821.1 ± 1586.8 days (see Table). Two (0.07%) patients had lead-related fibrin on ICE imaging. There was no significant difference in lead(s) threshold, impedance, or sensing post-procedure or at 30-days follow-up compared to pre-procedure (see Table). There were no intra- or post-op thromboembolic events or subsequent device infection over 30 days of follow-up. None of the patients required lead revision. One patient underwent CIED extraction after 11 months for an unrelated secondary device infection. Conclusion: Radiofrequency catheter ablation for AF can be safely performed without fluoroscopy in patients with CIED.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
