Step by step: How to perform a fluoroless cryoballoon ablation for atrial fibrillation

Abstract

Introduction Pulmonary vein isolation is the cornerstone of ablation of atrial fibrillation. With widespread use of 3D Electroanatomic Mapping Systems and advances in intracardiac echo imaging, fluoroless ablation has been possible. Methods Fluoroless ablation with cryoballoon (CB), however, has not been widely performed because of the need to prove occlusion of the vein with contrast dye and fluoroscopy. Results and Conclusion In this step‐by‐step guide, the authors will show how a CB ablation can be performed without the use of fluoroscopy.

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation

“…Commonly, a four-step grading score is used to describe the degree of occlusion 912 although other imaging modalities such as TEE or ICE may be used to reduce fluoroscopy exposure to near zero ( Section 7.6 .). 913 Invasive pressure monitoring through the central lumen has been described as a reliable tool to assess PV occlusion. 914 Very recently, wide band dielectric imaging, a non-fluoroscopic imaging modality, was reported to accurately assess PV occlusion and guide cryoballoon-based PVI.…”