Use of intracardiac echocardiography during atrial fibrillation ablation to avoid complications

Antral pulmonary vein isolation is the cornerstone of current catheter ablation techniques. As technology and tools for performing the ablations have evolved and improved over the past decade, the safety and efficacy of the procedure have improved. The availability of preprocedure imaging, such as MRI and CT scan and intraprocedure imaging, especially intracardiac echocardiography, gives the operator the ability to have very accurate real-time representations of the cardiac anatomy with visualization of catheter positioning and for assessing for potential complications before they become clinically manifest. Much attention has been paid to decreasing the reliance on use of fluoroscopy and the safety of both the patient as well as the operator. This chapter reviews several aspects of the utility of intracardiac echocardiography imaging in minimizing complications during atrial fibrillation ablation.