Arrhythmias & electrophysiology
Ensuring catheter-tissue contact with intracardiac echocardiography during pulsed-field ablation improves procedure outcome in patients with atrial fibrillation
Main finding · Reconnection of previously ablated structures at redo procedureResult — go to the resultOdds ratio 8.548 95% CI 3.224–22.667Authors' conclusion
ICE-guided PFA with confirmed catheter-tissue contact was associated with a better success rate and a significantly lower reconnection rate in patients with AF.
Study context
- Population
- Consecutive patients with paroxysmal and persistent atrial fibrillation (AF) undergoing their first pulsed-field ablation (PFA) procedure
- Participants
- 310 vs 286
- Exposure
- Intracardiac echocardiography (ICE)-guided vs fluoroscopy-guided PFA
- ICEn = 310
- Fluoron = 286reference
- Outcome
- Reconnection rate of previously ablated targets
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Reconnection of previously ablated structures at redo procedure
Odds ratio
8.548
95% CI 3.224–22.667
P < 0.001
Events by group
Fluorovs ICE
OR 8.548 (95% CI 3.224–22.667); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | ICE | Fluoro | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Arrhythmia recurrence · end of follow-upIndependent predictor of recurrence | 12.6% | 22.3% | 1.221 (1.001–1.971) | P = 0.021 | |
| 0.512Odds ratio (log scale) |
- Arrhythmia recurrence: between-group P = .002
Original publication
Ensuring catheter-tissue contact with intracardiac echocardiography during pulsed-field ablation improves procedure outcome in patients with atrial fibrillation. Heart Rhythm. Published 23 May 2025. doi:10.
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