{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T21:50:40Z","timestamp":1778622640821,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,30]],"date-time":"2018-04-30T00:00:00Z","timestamp":1525046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Radiofrequency catheter ablation of atrial fibrillation (AF) is one of the most complex ablation procedures. Both patients and operators are exposed to scattered radiation. This study evaluated the safety and efficacy of intracardiac echo (ICE)\u2010guided pulmonary vein isolation (PVI) without fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed the data of 481 consecutive patients with paroxysmal AF undergoing radiofrequency PVI with the CARTO 3 system (Biosense Webster, Diamond Bar, CA, USA). ICE\u2010guided PVI without fluoroscopy and without CT\/MRI integration (Nonfluoro group) was performed for 245 patients, and conventional fluoroscopy\u2010guided PVI (Fluoro group) was performed for 236 patients. The primary safety endpoint was the incidence of major adverse events. The primary efficacy endpoint was freedom from AF during follow\u2010up. Secondary endpoints included procedure duration, fluoroscopy duration, and acute PVI rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean procedure times between groups were similar (108.8 \u00b1 18.2\u00a0minutes in the Non\u2010fluoro group vs 113.6 \u00b1 26.8\u00a0minutes in the Fluoro group; P\u00a0\u00a0=\u00a0\u00a0not significant [NS]). Acute PVI was achieved in all patients, with mean radiofrequency application times of 43.4 \u00b1 7.5 and 44.4 \u00b1 10.7\u00a0minutes for the Nonfluoro and Fluoro groups, respectively (P\u00a0\u00a0=\u00a0\u00a0NS). The incidence of cardiac tamponade was 1.2% (3\/245 patients) in the Nonfluoro group and 0.8% (2\/236 patients) in the Fluoro group (P\u00a0\u00a0=\u00a0\u00a0NS). During 15.2 \u00b1 4.1 months of follow\u2010up, after a single procedure, AF recurrence was documented in 65 of 245 (26.5%) patients and 61 of 236 (25.8%) patients in the Nonfluoro and Fluoro groups, respectively (P\u00a0\u00a0=\u00a0\u00a0NS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nonfluoroscopic ICE\u2010guided catheter ablation of AF without prior cardiac image integration or angiography is feasible and safe. PVI without fluoroscopy did not affect procedure duration or long\u2010term efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13321","type":"journal-article","created":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T18:28:19Z","timestamp":1521743299000},"page":"611-619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Nonfluoroscopic catheter ablation of paroxysmal atrial fibrillation"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-9227","authenticated-orcid":false,"given":"Evgeny","family":"Lyan","sequence":"first","affiliation":[{"name":"Mechnikov North\u2010West State Medical University  Saint Petersburg Russia"},{"name":"Herz\u2010 und Gef\u00e4\u00dfzentrum  Bad Bevensen 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North\u2010West State Medical University  Saint Petersburg Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland Richard","family":"Tilz","sequence":"additional","affiliation":[{"name":"University Heart Center  Luebeck Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noureddin","family":"Sawan","sequence":"additional","affiliation":[{"name":"Herz\u2010 und Gef\u00e4\u00dfzentrum  Bad Bevensen 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