Ablation Procedures
Imaging with ICE during ablation procedures can be useful to assess for
device-tissue contact and perhaps lesion formation. During PV isolation
procedures using the cryoballoon in the present series, standard 2D
images with color Doppler were acquired from the RA and proved useful to
assess for PV occlusion. In addition, 4D images were used at times to
detect a leak around the balloon in a plane that the 2D images might
have missed. This may enable operators to use less fluoroscopy and less
contrast when checking for balloon occlusion. However, obtaining optimal
4D images requires clear 2D images, which can sometimes be difficult
from the RA in patients with a thick atrial septum. The ability to
digitally steer the image angle, though, can help optimize these images.
Additional imaging from the LA during CBA provided outstanding views of
the cryoballoon. Unfortunately, however, it was more difficult than
anticipated to view the PVs beyond or through the balloon to assess for
occlusion.