{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T21:50:10Z","timestamp":1770414610979,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,10,26]],"date-time":"2017-10-26T00:00:00Z","timestamp":1508976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stochastic damage of the ionizing radiation to both patients and medical staff is a drawback of fluoroscopic guidance during catheter ablation of cardiac arrhythmias. Therefore, emerging zero\u2010fluoroscopy catheter\u2010guidance techniques are of great interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>We investigated, in a prospective pilot study, the feasibility and safety of the cryothermal (CA) slow\u2010pathway ablation in patients with symptomatic atrioventricular\u2010nodal\u2010re\u2010entry\u2010tachycardia (AVNRT) using solely intracardiac echocardiography (ICE) for endovascular and endocardial catheter visualization. Twenty\u2010five consecutive patients (mean age 55.6 \u00b1 12.0 years, 17 female) with ECG\u2010documentation or symptoms suggesting AVNRT underwent an electrophysiology study (EPS) in our laboratory utilizing ICE for catheter navigation. Supraventricular tachycardia was inducible in 23 (92%) patients; AVNRT was confirmed by appropriate stimulation maneuvers in 20 (80%) patients. All EPS in the AVNRT subgroup could be accomplished without need for fluoroscopy, relying solely on ICE\u2010guidance. CA guided by anatomical location and slow\u2010pathway potentials was successful in all patients, median cryo\u2010mappings\u00a0=\u00a06 (IQR:3\u201310), median cryo\u2010ablations\u00a0=\u00a02 (IQR:1\u20133). Fluoroscopy was used to facilitate the trans\u2010septal puncture and localization of the ablation substrate in the remaining 3 patients (one focal atrial tachycardia and two atrioventricular\u2010re\u2010entry\u2010tachycardias). Mean EPS duration in the AVNRT subgroup was 99.8 \u00b1 39.6\u00a0minutes, ICE guided catheter placement 11.9 \u00b1 5.8\u00a0minutes, time needed for diagnostic evaluation 27.1 \u00b1 10.8\u00a0minutes, and cryo\u2010application duration 26.3 \u00b1 30.8\u00a0minutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ICE\u2010guided zero\u2010fluoroscopy CA in AVNRT patients is feasible and safe. Real\u2010time visualization of the true endovascular borders and cardiac structures allow for safe catheter navigation during the ICE\u2010guided EPS and might be an alternative to visualization technologies using geometry reconstructions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13354","type":"journal-article","created":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T15:32:51Z","timestamp":1506612771000},"page":"160-166","source":"Crossref","is-referenced-by-count":17,"title":["Zero\u2010fluoroscopy cryothermal ablation of atrioventricular nodal re\u2010entry tachycardia guided by endovascular and endocardial catheter visualization using intracardiac echocardiography (Ice&amp;ICE Trial)"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2404-8984","authenticated-orcid":false,"given":"Blerim","family":"Luani","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Zrenner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Pulmology and Angiology Landshut\u2010Achdorf Hospital  Landshut Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maksim","family":"Basho","sequence":"additional","affiliation":[{"name":"Department of Radiology University Hospital Center Mother Teresa  Tirana Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conrad","family":"Genz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Rauwolf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Tanev","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Schmeisser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00fcdiger C.","family":"Braun\u2010Dullaeus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology and Angiology Magdeburg University  Magdeburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,26]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"1575","article-title":"ACC\/AHA\/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"67","author":"Page RL","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"2226","DOI":"10.1016\/j.ehj.2004.07.020","article-title":"Transvenous cryoablation versus radiofrequency ablation of the slow pathway for the treatment of atrioventricular nodal re\u2010entrant tachycardia: A prospective randomized pilot study","volume":"25","author":"Zrenner B","year":"2004","journal-title":"Eur Heart J"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12247"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12339"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv344"},{"key":"e_1_2_5_7_1","volume-title":"Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2","author":"Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation; Nuclear and Radiation Studies Board, Division on Earth and Life Studies, National Research Council of the National Academies","year":"2006"},{"key":"e_1_2_5_8_1","first-page":"892","article-title":"ACC expert consensus document. 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