Workflow of the zero-fluoro pulsed field ablation.

BACKGROUND

Zero-fluoroscopic pulsed field ablation (PFA) is the next step in advancing pulmonary vein isolation (PVI) for atrial fibrillation (AF).

METHODS

A workflow incorporating a variable-loop circular PFA catheter, intracardiac echocardiography (ICE), and a visualized sheath was applied to 15 paroxysmal AF patients.

RESULTS

It consisted of three steps: (1) positioning a non-magnetic mapping catheter in the coronary sinus after creating a right atrial matrix, (2) transseptal puncture with the sheath advancement to the left atrium under ICE guidance, and (3) PFA confirming catheter-tissue contact with tissue proximity indication.

CONCLUSIONS

This zero-fluoro PFA workflow is feasible without advanced technique.