Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis
BackgroundPulmonary vein isolation (PVI) is a cornerstone of catheter ablation for atrial fibrillation (AF). Intracardiac echocardiography (ICE) offers real-time imaging that may enhance procedural outcomes compared to traditional x-ray guidance. This study evaluates the impact of ICE on PVI lesion...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1612181/full |
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| author | Ye Deng Li Deng Qingqing Gu Qianwen Chen Yang Zhang Jun Wei Xu Liu Yuan Ji Ling Sun Qingjie Wang |
| author_facet | Ye Deng Li Deng Qingqing Gu Qianwen Chen Yang Zhang Jun Wei Xu Liu Yuan Ji Ling Sun Qingjie Wang |
| author_sort | Ye Deng |
| collection | DOAJ |
| description | BackgroundPulmonary vein isolation (PVI) is a cornerstone of catheter ablation for atrial fibrillation (AF). Intracardiac echocardiography (ICE) offers real-time imaging that may enhance procedural outcomes compared to traditional x-ray guidance. This study evaluates the impact of ICE on PVI lesion quality and efficiency using a novel Ablation Index Functional Validation (AIFV) system.MethodsThis single-center, retrospective, matched cohort study included AF patients undergoing catheter ablation between June 2022 and June 2023 at The Third Affiliated Hospital of Nanjing Medical University. Patients were grouped based on ICE use (ICE vs. No-ICE), with intraoperative data recorded via the VisiTag system and analyzed by AIFV. Propensity score matching (1:1) was applied to compare procedural efficiency and lesion quality (primary endpoints) and AF recurrence (secondary endpoint) between groups.ResultsOf 126 patients enrolled (61 ICE, 65 No-ICE), 46 matched pairs were analyzed. PVI was achieved in all cases without severe complications. The ICE group demonstrated significantly shorter total PVI time [2,819 s (2,565 s, 2,953 s) vs. 3,153 s (2,696 s, 3,831 s), p = 0.006], higher radiofrequency (RF) time ratio (59.1% ± 13.9% vs. 48.2% ± 11.6%, p < 0.001), and higher effective ablation-index (AI) ratio (96.1% ± 4.5% vs. 91.2% ± 3.9%, p < 0.001) compared to the No-ICE group. Left and right PVI times were also reduced (p = 0.034 and p = 0.029, respectively). At 12-month follow-up, AF recurrence rates were significantly lower in the ICE group (7.7% vs. 30.8%, p = 0.038) in persistent AF patients.ConclusionICE enhances the quality of lesions and the ablation efficiency of PVI in AF patients, as shown by the AIFV system. |
| format | Article |
| id | doaj-art-6eaf5886846142a8a3e773a70dc43773 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-6eaf5886846142a8a3e773a70dc437732025-08-20T03:28:21ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-07-011210.3389/fcvm.2025.16121811612181Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysisYe Deng0Li Deng1Qingqing Gu2Qianwen Chen3Yang Zhang4Jun Wei5Xu Liu6Yuan Ji7Ling Sun8Qingjie Wang9Department of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, ChinaDepartment of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, ChinaDepartment of Research and Development, Johnson & Johnson (Shanghai) Medical Equipment Co, Ltd, Shanghai, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaDepartment of Cardiology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, ChinaDepartment of Cardiology, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, ChinaBackgroundPulmonary vein isolation (PVI) is a cornerstone of catheter ablation for atrial fibrillation (AF). Intracardiac echocardiography (ICE) offers real-time imaging that may enhance procedural outcomes compared to traditional x-ray guidance. This study evaluates the impact of ICE on PVI lesion quality and efficiency using a novel Ablation Index Functional Validation (AIFV) system.MethodsThis single-center, retrospective, matched cohort study included AF patients undergoing catheter ablation between June 2022 and June 2023 at The Third Affiliated Hospital of Nanjing Medical University. Patients were grouped based on ICE use (ICE vs. No-ICE), with intraoperative data recorded via the VisiTag system and analyzed by AIFV. Propensity score matching (1:1) was applied to compare procedural efficiency and lesion quality (primary endpoints) and AF recurrence (secondary endpoint) between groups.ResultsOf 126 patients enrolled (61 ICE, 65 No-ICE), 46 matched pairs were analyzed. PVI was achieved in all cases without severe complications. The ICE group demonstrated significantly shorter total PVI time [2,819 s (2,565 s, 2,953 s) vs. 3,153 s (2,696 s, 3,831 s), p = 0.006], higher radiofrequency (RF) time ratio (59.1% ± 13.9% vs. 48.2% ± 11.6%, p < 0.001), and higher effective ablation-index (AI) ratio (96.1% ± 4.5% vs. 91.2% ± 3.9%, p < 0.001) compared to the No-ICE group. Left and right PVI times were also reduced (p = 0.034 and p = 0.029, respectively). At 12-month follow-up, AF recurrence rates were significantly lower in the ICE group (7.7% vs. 30.8%, p = 0.038) in persistent AF patients.ConclusionICE enhances the quality of lesions and the ablation efficiency of PVI in AF patients, as shown by the AIFV system.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1612181/fullatrial fibrillationcatheter ablationpulmonary vein isolationintracardiac echocardiographyrecurrance |
| spellingShingle | Ye Deng Li Deng Qingqing Gu Qianwen Chen Yang Zhang Jun Wei Xu Liu Yuan Ji Ling Sun Qingjie Wang Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis Frontiers in Cardiovascular Medicine atrial fibrillation catheter ablation pulmonary vein isolation intracardiac echocardiography recurrance |
| title | Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis |
| title_full | Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis |
| title_fullStr | Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis |
| title_full_unstemmed | Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis |
| title_short | Intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients: a propensity score-matched analysis |
| title_sort | intracardiac echocardiography improves lesion quality and ablation efficiency of pulmonary vein isolation in atrial fibrillation patients a propensity score matched analysis |
| topic | atrial fibrillation catheter ablation pulmonary vein isolation intracardiac echocardiography recurrance |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1612181/full |
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