The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

Callans, David J.; Anter, Elad; Hutchinson, Mathew D.

doi:10.4022/jafib.v1i9.553

Cited by 3 publications

(7 citation statements)

References 11 publications

(21 reference statements)

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“…Routine indications for measurements are not yet implemented [ 53 ], even if alteration of LA phasic functions are described and studied in many cardiovascular conditions, with an emphasis on AF [ 54 ]. An important limitation of LA functions using volumetric differences is that these parameters are derivative and incorrect evaluation of 2D-E LA volumes could potentially determine a modification of emptying fractions [ 55 ].…”

Section: Left Atrial Function In Afmentioning

confidence: 99%

“…This ratio seems to have a clinical relevance in risk stratification in patients with AF. A ratio over 11.2 was determined as a predictor for early AF recurrences [ 55 ], while a higher ratio, over 13.25, was established as an independent predictor for late AF recurrences [ 75 ]. A septal E/E’ ratio over 15 was evaluated as an independent predictor of mortality in patients with AF [ 81 ].…”

Section: Left Atrial Function In Afmentioning

confidence: 99%

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Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Matei¹,

Popescu²,

Popescu³

et al. 2022

Rev. Cardiovasc. Med.

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Atrial fibrillation (AF) results from structural and electrical remodeling of the atria, primarily of the left atrium (LA); therefore, LA changes, both anatomical and functional are recognized as proarrhythmic markers with a powerful prognostic value. Being widely available and noninvasive, echocardiography is used to monitor LA form and function in clinical practice. Early functional (electrical) remodeling of the LA precedes anatomical alterations. Impaired LA functions and reduced atrial compliance due to atrial fibrosis may be evaluated using novel echocardiographic techniques, such as tissue Doppler analysis and speckle tracking. Functional evaluation of the LA conveys prognostic information about the risk of AF, as the severity of the impairment is an independent predictor of new-onset AF and AF recurrence. However, specific parameters are still investigated for incorporation into algorithms to predict future AF occurrence. The aim of the review is to summarize echocardiographic parameters, their predicting value and applicability in practice.

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Section: Left Atrial Function In Afmentioning

confidence: 99%

Section: Left Atrial Function In Afmentioning

confidence: 99%

Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Matei¹,

Popescu²,

Popescu³

et al. 2022

Rev. Cardiovasc. Med.

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Section: Introductionunclassified

“…Echocardiography also has the potential to increase patient safety by early identification of procedure-related complications and to reduce patient and staff radiation exposure by decreasing dependency on fluoroscopy. 5 …”

Section: Introductionmentioning

confidence: 99%

“…O ecocardiograma também tem o potencial de aumentar a segurança do paciente pela identificação precoce de complicações relacionadas ao procedimento e de reduzir a exposição à radiação do paciente e da equipe ao diminuir a dependência da fluoroscopia. 5 Duas formas de ecocardiografia têm sido utilizadas na cardiologia intervencionista: transesofágica (ETE) e intracardíaca (EIC). O ETE oferece imagens superiores em resolução e menor custo inicial, pois a sonda é reutilizável.…”

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Ablação da Fibrilação Atrial: Impacto da Ecocardiografia Intracardíaca na Redução do Tempo de Procedimento e Internação

Sant`Anna¹,

Lima²,

Saffi³

et al. 2023

Arquivos Brasileiros De Cardiologia

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Resumo Fundamento O ecocardiograma intracardíaco (EIC) permite visualizar estruturas cardíacas e reconhecer complicações durante a ablação da fibrilação atrial (AFA). Comparado ao ecocardiograma transesofágico (ETE), o EIC é menos sensível para detecção de trombo no apêndice atrial, porém requer mínima sedação e menos operadores, tornando-o atrativo num cenário de recursos restritos. Objetivo Comparar 13 casos de AFA utilizando EIC (grupo AFA-EIC) com 36 casos de AFA utilizando ETE (grupo AFA-ETE). Método Trata-se de corte prospectiva realizada em um único centro. O desfecho principal foi o tempo de procedimento. Desfechos secundários tempo de fluoroscopia, dose de radiação (mGy/cm2), complicações maiores e tempo de internação hospitalar em horas. O perfil clínico foi comparado pelo escore CHA2DS2-VASc. Um valor de p <0,05 foi considerado uma diferença estatisticamente significativa entre os grupos. Resultados A mediana do escore de CHA2DS2-VASc score foi 1 (0-3) no grupo AFA-EIC e 1 (0-4) no grupo AFA-ETE. O tempo total de procedimento foi de 129 ± 27 min grupo AFA-EIC e 189 ± 41 no AFA-ETE (p<0,001); o grupo AFA-EIC recebeu uma dose menor de radiação (mGy/cm2, 51296 ± 24790 vs. 75874 ± 24293; p=0,002), no entanto, o tempo de fluoroscopia em minutos mostrou-se semelhante (27,48 ± 9,79 vs. 26,4 ± 9,32; p=0,671). As medianas do tempo de hospitalização não se mostraram diferentes, 48 (36-72) horas (AFA-EIC) e 48 (48-66) horas (AFA-ETE) (p=0,27). Conclusão Nesta coorte, AFA-EIC foi relacionado a menores tempos de procedimento e menor exposição à radiação, sem aumentar o risco de complicações ou o tempo de internação hospitalar.

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The Use of Artificial Intelligence for Detecting and Predicting Atrial Arrhythmias Post Catheter Ablation

Lallah,

Laite,

Bangash

et al. 2023

Rev. Cardiovasc. Med.

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Catheter ablation (CA) is considered as one of the most effective methods technique for eradicating persistent and abnormal cardiac arrhythmias. Nevertheless, in some cases, these arrhythmias are not treated properly, resulting in their recurrences. If left untreated, they may result in complications such as strokes, heart failure, or death. Until recently, the primary techniques for diagnosing recurrent arrhythmias following CA were the findings predisposing to the changes caused by the arrhythmias on cardiac imaging and electrocardiograms during follow-up visits, or if patients reported having palpitations or chest discomfort after the ablation. However, these follow-ups may be time-consuming and costly, and they may not always determine the root cause of the recurrences. With the introduction of artificial intelligence (AI), these follow-up visits can be effectively shortened, and improved methods for predicting the likelihood of recurring arrhythmias after their ablation procedures can be developed. AI can be divided into two categories: machine learning (ML) and deep learning (DL), the latter of which is a subset of ML. ML and DL models have been used in several studies to demonstrate their ability to predict and identify cardiac arrhythmias using clinical variables, electrophysiological characteristics, and trends extracted from imaging data. AI has proven to be a valuable aid for cardiologists due to its ability to compute massive amounts of data and detect subtle changes in electric signals and cardiac images, which may potentially increase the risk of recurrent arrhythmias after CA. Despite the fact that these studies involving AI have generated promising outcomes comparable to or superior to human intervention, they have primarily focused on atrial fibrillation while atrial flutter (AFL) and atrial tachycardia (AT) were the subjects of relatively few AI studies. Therefore, the aim of this review is to investigate the interaction of AI algorithms, electrophysiological characteristics, imaging data, risk score calculators, and clinical variables in predicting cardiac arrhythmias following an ablation procedure. This review will also discuss the implementation of these algorithms to enable the detection and prediction of AFL and AT recurrences following CA.

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The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation

Cited by 3 publications

References 11 publications

Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Ablação da Fibrilação Atrial: Impacto da Ecocardiografia Intracardíaca na Redução do Tempo de Procedimento e Internação

The Use of Artificial Intelligence for Detecting and Predicting Atrial Arrhythmias Post Catheter Ablation

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