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Advanced electroanatomic mapping and contact force-sensing catheters have improved outcomes, increased efficiency, and significantly reduced the need for fluoroscopy during radiofrequency ablation of atrial fibrillation (AF). However, fluoroscopic guidance is still routinely used for the procedure, posing a long-term risk to the patient, the operator, and laboratory staff. Furthermore, rapid high-density mapping has diminished the need for a second multipolar or circular left atrial catheter to demonstrate electrical isolation of pulmonary veins. We describe a novel approach to AF ablation using only intracardiac echo guidance, a decapolar coronary sinus catheter, and a single ablation catheter in the left atrium. Mapping is performed using the CARTO-3 system with Confidense module (Biosense Webster, Diamond Bar, CA) to achieve and verify pulmonary vein isolation.

Zero-fluoroscopy Intracardiac Echocardiography-guided Ablation of Atrial Fibrillation Using a Single-catheter Technique