{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T13:34:35Z","timestamp":1786714475585,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Pulsed\u2010field ablation (PFA) is an emerging technique for pulmonary vein isolation in atrial fibrillation. However, its implementation is commonly guided by fluoroscopy with or without 3D electroanatomic mapping, increasing either radiation exposure or procedural cost. We describe a practical, step\u2010by\u2010step workflow for performing completely fluoroless pulmonary vein isolation using a pentaspline PFA ablation catheter guided exclusively by intracardiac echocardiography (ICE). All procedural stages\u2014including transseptal access, intracardiac navigation, catheter deployment, energy delivery, and acute assessment of electrical isolation\u2014are performed under continuous ICE visualization. Although this workflow is designed for pulmonary vein isolation, selected examples of extra\u2010pulmonary vein ablation guided by ICE are included to illustrate catheter manipulation and energy delivery. This ICE\u2010only approach suggests that fluoroless PFA is achievable using continuous ICE guidance while avoiding radiation exposure. In centers where the combined use of ICE and 3D mapping systems may be limited, this workflow may also represent a practical alternative for the treatment of atrial fibrillation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70403","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:10:37Z","timestamp":1781633437000},"page":"1846-1863","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Step\u2010by\u2010Step: How to Perform Pulsed Field Ablation of Atrial Fibrillation Guided Exclusively by Intracardiac Echocardiography Using a Pentaspline Catheter"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9716-2599","authenticated-orcid":false,"given":"David","family":"Santacruz\u2010Pacheco","sequence":"first","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Service Cl\u00ednica Las Vegas Medell\u00edn Colombia"},{"name":"Cardiac Electrophysiology Service Cl\u00ednica Las Am\u00e9ricas Medell\u00edn Colombia"},{"name":"Universidad CES Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"P\u00e9rez\u2010Silva","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Unit Hospital Regional Concepci\u00f3n Concepci\u00f3n Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Astudillo","sequence":"additional","affiliation":[{"name":"Universidad CES Medell\u00edn Colombia"},{"name":"Cardiac Electrophysiology Unit Cl\u00ednica El Rosario Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan M.","family":"Camargo","sequence":"additional","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F.","family":"Betancourt","sequence":"additional","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime F.","family":"Rosas","sequence":"additional","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor M.","family":"Velasco","sequence":"additional","affiliation":[{"name":"Arrhythmia Institute and Department of Cardiac Electrophysiology Fundaci\u00f3n Cl\u00ednica Shaio Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri","family":"Sundaram","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology Unit South Denver Cardiology Associates Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Other Members of the ICE\u2010Guided Pentaspline PFA Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2019422"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_18_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_18_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.125.013977"},{"key":"e_1_2_18_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.11.031"},{"key":"e_1_2_18_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064959"},{"key":"e_1_2_18_8_1","article-title":"State\u2010of\u2010the\u2010Art Pulsed Field Ablation for Cardiac Arrhythmias: Ongoing Evolution and Future Perspective","volume":"26","author":"Chun K. 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