{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:16:55Z","timestamp":1787015815838,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,6,11]],"date-time":"2020-06-11T00:00:00Z","timestamp":1591833600000},"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":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary vein isolation (PVI) with a cryoballoon usually uses iodinated contrast medium for confirmation of venous occlusion. We hypothesized that an alternative to angiography with iodinated contrast, saline bolus\u2010enhanced echocardiography with the microbubbles formed in situ, could be used to assess venous occlusion. We sought to assess the efficacy and safety of the contrast\u2010enhanced intracardiac echocardiographic (ICE) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010four consecutive patients without iodine sensitivity or renal insufficiency were studied to assess the accuracy of ICE\u2010guided PV occlusion underwent both angiographic guidance and ICE guidance (validation group). Twenty consecutive patients with paroxysmal atrial fibrillation (AF) and contraindications to iodinated contrast medium (ICE\u2010guided group) underwent PV occlusion and ablation with ICE guidance alone. Procedural results and clinical outcomes were compared with those of 245 control patients undergoing PVI by the conventional angiographic method (control group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the validation group, ICE\u2010guided PV occlusion was as effective as angiography\u2010guided PV occlusion. In the ICE\u2010guided group, two patients required touch\u2010up ablation using a radiofrequency ablation catheter with fluoroscopic guidance. Procedure time, radiation exposure, and requirements for touch\u2010up ablation were similar between the ICE\u2010guided group and the control group. In patients requiring only PVI, the ICE\u2010guided approach involved significantly less radiation exposure than the conventional approach. There was no significant difference in atrial fibrillation (AF)\u2010free survival rate between the two groups during a follow\u2010up period of 14 \u00b1 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An echo\u2010guided approach using saline infusion was effective in terms of avoidance of iodinated contrast use and radiation exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.13945","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T06:57:36Z","timestamp":1589785056000},"page":"664-670","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A saline contrast\u2010enhanced echocardiography\u2010guided approach to cryoballoon ablation"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1049-4924","authenticated-orcid":false,"given":"Takashi","family":"Kanda","sequence":"first","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-466X","authenticated-orcid":false,"given":"Masaharu","family":"Masuda","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Kurata","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsutoshi","family":"Asai","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyonori","family":"Nanto","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Tsujimura","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Okuno","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Hata","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Mano","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital Cardiovascular Center  Amagasaki Hyogo 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