Intracardiac Versus Transesophageal Echocardiography Versus Fluoroscopy Only Guidance for Combined Catheter Ablation for Atrial Fibrillation and Left Atrial Appendage Occlusion
Intracardiac Versus Transesophageal Echocardiography Versus Fluoroscopy Only Guidance for Combined Catheter Ablation for Atrial Fibrillation and Left Atrial Appendage Occlusion
A total of 75 patients with atrial fibrillation were scheduled to receive left atrial
 appendage occlusion combined with radiofrequency ablation, which were divided into 3 groups.
 The operation was performed under the guidance of intracardiac echocardiography and
 transesophageal echocardiography and fluoroscope only respectively (allocation ratio 1:1:1).
 During the operation, the total amount of contrast medium injected, the fluoroscopy time and
 the time from femoral vein puncture to transseptal puncture to closure were recorded in all
 patients. All patients underwent transesophageal echocardiography before and 3 months after
 operation, and the results were explained by two experienced ultrasound doctors to measure
 the presence of left atrial thrombus, residual shunt and device-related thrombus. All
 patients were examined by transthoracic echocardiography 3 months after operation to evaluate
 new pericardial effusion, pericardial tamponade, instrument embolization / displacement and
 so on. The baseline clinical and surgical features and hospitalization outcomes of patients
 guided by ICE and TEE and fluoroscopy only were recorded and compared. Clinical endpoints
 include death, new pericardial effusion that does not require pericardiocentesis, tamponade
 with pericardiocentesis, instrument embolism / displacement, bleeding at the entry site,
 thromboembolic events (stroke / transient ischemic attack [TIA]). The purpose of this study
 was to evaluate the feasibility, safety and effectiveness of intracardiac echocardiographic
 (ICE)-guided and transesophageal echocardiographic (TEE)-guided and fluoroscopy only-guided
 left atrial appendage occlusion combined with radiofrequency ablation. The average follow-up
 time is 3 months.
Inclusion Criteria:

 AF attack occurred in patients with a duration of more than one year, patients taking class
 I and class III antiarrhythmic drugs could not prevent AF, patients younger than 80 years
 old Cha2ds2-vasc score ≥2 and HAS-BLED score ≥3, not suitable for long-term oral
 anticoagulant drugs.

 Exclusion Criteria:

 Patients with a history of atrial thrombosis or valvular heart disease (moderate or severe
 valve stenosis or severe valve regurgitation), patients undergoing prosthetic heart valve
 replacement, pregnant women, patients with previous liver and kidney diseases, malignant
 tumors or blood system diseases.