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Fluoroless catheter ablation of atrial fibrillation

Published:February 15, 2017DOI:https://doi.org/10.1016/j.hrthm.2017.02.016
      Although the concept of performing fluoroless catheter ablation of atrial fibrillation (AF) was introduced several years ago, it has yet to gain wide adoption.
      • Ferguson J.D.
      • Helms A.
      • Mangrum J.M.
      • Mahapatra S.
      • Mason P.
      • Bilchick K.
      • McDaniel G.
      • Wiggins D.
      • DiMarco J.P.
      Catheter ablation of atrial fibrillation without fluoroscopy using intracardiac echocardiography and electroanatomic mapping.
      • Reddy V.Y.
      • Morales G.
      • Ahmed H.
      • Neuzil P.
      • Dukkipati S.
      • Kim S.
      • Clemens J.
      • D'Avila A.
      Catheter ablation of atrial fibrillation without the use of fluoroscopy.
      Despite its well-documented advantages, there are several impediments, including concern that a fluoroless approach will add time to the procedure and may require a second operator. However, perhaps the greatest obstacle is that many electrophysiologists are trained to rely on fluoroscopic imaging and are therefore reluctant to trust intracardiac echocardiography (ICE) as their primary visual modality for tracking catheter movement and manipulation. Fortunately, this concern can be remediated with experience, since the learning curve for a fluoroless procedure is steep and the required skill set can be readily acquired. The most critical requisite for performing fluoroless AF ablation is a willingness to relinquish an old habit.

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