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Updated: Jan 21, 2026

Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Comparing Left Versus Right Atrial Intracardiac Echocardiography in Pulsed Field Ablation for Atrial Fibrillation
Kohki Kimura1, Jun Morita1, Makoto Idoji1
1Cardiovascular Center, Medical Research Institute Kitano Hospital, Osaka City, Osaka, Japan.
Background:
Pulsed field ablation (PFA) is an emerging, effective therapy for atrial fibrillation (AF). Achieving adequate catheter-to-tissue contact is crucial, as poor contact can result in pulmonary vein (PV) reconnection or hemolysis. Intracardiac echocardiography (ICE) enables real-time visualization of the PFA catheter and PV anatomy. To compare the utility of left atrial (LA) versus right atrial (RA) ICE placement during PFA for AF.
Methods:
We retrospectively analyzed 53 consecutive AF patients who underwent index PFA procedures (FARAWAVE, Boston Scientific). Patients were stratified into two groups according to ICE location: RA-ICE (n = 20) and LA-ICE (n = 33). Procedural characteristics and image quality of catheter and PV anatomy were evaluated.
Results:
The total number of PFA applications was higher in the LA-ICE group than in the RA-ICE group (45.6 ± 6.8 vs. 35.8 ± 3.4, p < 0.01). Nevertheless, LA-ICE was associated with a shorter LA dwell time (45.4 ± 13.3 vs. 55.0 ± 17.1 min, p = 0.04) and PV isolation time (19.6 ± 3.9 vs. 25.4 ± 10.5 min, p = 0.01). Visualization of catheter configuration and PV anatomy was significantly better in the LA-ICE group, particularly for the left inferior and right-sided PVs (p < 0.01).
Conclusions:
ICE placement in the LA improved visualization of the PFA catheter and PV anatomy, resulting in reduced PV isolation and LA dwell times compared with RA-ICE.
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