Open AccessReal-time three-dimensional transesophageal echocardiography-guided atrial fibrillation ablation procedure
Author(s) -
Valentina Kutyifa,
Béla Merkely,
Vivien Klaudia Nagy,
Astrid Apor,
Endre Zima,
László Gellér
Publication year - 2011
Publication title -
interventional medicine and applied science/interventional medicine and applied science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.195
H-Index - 14
eISSN - 2061-5094
pISSN - 2061-1617
DOI - 10.1556/imas.3.2011.3.2
Subject(s) - fossa ovalis , medicine , interatrial septum , atrial fibrillation , pulmonary vein , ablation , fluoroscopy , catheter ablation , catheter , cardiology , radiology , left atrium
Background Real-time three-dimensional transesophageal echocardiography (RT 3D TEE) is a novel method providing high spatial and temporal resolution imaging of the heart. During pulmonary vein isolation procedures visualization of the atria, interatrial septum and the ablation catheter is of high importance to increase safety. RT 3D TEE might be a useful tool to guide left atrial ablations. Case report A 53-year-old man was referred to our hospital to undergo pulmonary vein isolation procedure for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. The transseptal puncture was performed under RT 3D TEE-guidance with direct visualization of the interatrial septum and fossa ovalis. RT 3D TEE provided a three-dimensional view of the puncture with “tenting”-sign and the transseptal needle-fossa ovalis angle enhancing the manipulation of the ablation catheter within the left atrium. The ablation catheter was visualized and tracked during the procedure. No adverse events occurred during the procedure. Conclusion Our case report demonstrates the feasibility of RT 3D TEE-guided atrial fibrillation ablation procedures. Safety profile might be improved by the real-time direct view of fossa ovalis. Decrease in fluoroscopy time can be achieved by visualizing the ablation catheter during the procedure.