Visualizable vs. standard, non-visualizable steerable sheath for pulmonary vein isolation procedures: Randomized,...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Steerable sheaths (SSs) are crucial for enhancing catheter stability during pulmonary vein isolation (PVI).
• A novel visualizable SS, integrated with electroanatomical mapping systems, is now available for clinical use.

Purpose of the Study:

• To compare procedural outcomes between visualizable and non-visualizable SS-assisted PVI in patients with atrial fibrillation (AF).

Main Methods:

• A single-center randomized study included 100 consecutive AF patients undergoing PVI.
• Patients were randomized into two groups: visualizable SS (n=50) and non-visualizable SS (n=50).
• Key procedural metrics were analyzed and compared between the groups.

Main Results:

• Both groups achieved 100% acute ablation success with similar first-pass isolation rates (92% vs. 89%).
• The visualizable SS group showed significantly reduced left atrial (LA) procedure time, LA fluoroscopy time, and LA fluoroscopy dose.
• Fewer radiofrequency applications and reduced total ablation time were observed with the visualizable SS, without compromising safety.

Conclusions:

• Visualizable SS significantly decreases LA procedure time, RF delivery, and fluoroscopy exposure in PVI for AF.
• The use of visualizable SS is safe and effective, offering potential advantages over standard non-visualizable SS.
• This technology enhances efficiency and reduces radiation burden for patients undergoing PVI.