Comparative study of fluoroscopy and intracardiac echocardiographic guidance for the creation of linear XXXX .

@entity75 @entity235 @entity955
BACKGROUND: Recently, attempts have been made to cure @entity955 by creating @entity75 with radiofrequency energy. Intracardiac echocardiography (ICE) offers imaging of endocardial anatomy and the ablation electrode-tissue interface not available with standard fluoroscopy. This study sought to prospectively compare fluoroscopic with ICE guidance for the creation of linear @entity75 in a @entity235 model. METHODS AND RESULTS: The creation of 3 linear @entity75 was attempted in each of 10 @entity235 , half guided by fluoroscopy alone and half by ICE. Coil-tissue contact was prospectively graded. After ablation, animals were euthanized, and the location and continuity of lesions were evaluated. ICE guidance led to a higher percentage of successful applications (P=0.02) and mean achieved temperature (P=0. 004). The contact scores of excellent, fair, and poor correlated well with successful energy delivery, mean temperature, and efficiency of heating (P<0.0001). In 25% of the blinded energy deliveries, the location, as determined by the ablation operator, differed from that of ICE. Pathological evaluation revealed improved lesion formation in the ICE-guided compared with the ICE-blinded group. Lesions were found outside the target areas in the ICE-blinded but not the ICE-guided group. CONCLUSIONS: Compared with fluoroscopy, ICE guidance improved targeting, energy delivery, and lesion formation in this @entity235 model. This study suggests that ICE guidance improves lesion formation and prevents energy delivery to potentially dangerous sites.
