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Review
. 2023 Aug;66(5):1291-1301.
doi: 10.1007/s10840-023-01469-0. Epub 2023 Feb 2.

Fluoroless catheter ablation of atrial fibrillation: a step-by-step workflow

Affiliations
Review

Fluoroless catheter ablation of atrial fibrillation: a step-by-step workflow

Andres Enriquez et al. J Interv Card Electrophysiol. 2023 Aug.

Abstract

Catheter ablation is an important therapeutic strategy for patients with atrial fibrillation (AF). While some critical steps of the procedure have traditionally relied on fluoroscopy, advances in electroanatomic mapping and the growing use of intracardiac echocardiography have made non-fluoroscopic AF ablation a reality. This hands-on review provides an overview on how to perform radiofrequency ablation of AF without the use of fluoroscopy, focusing on technical aspects, new technologies, and troubleshooting.

Keywords: Atrial fibrillation; Catheter ablation; Zero fluoroscopy.

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