Abstract: P1353

Impact of intracardiac echocardiography on electrical storm ablation

Authors:F. Turreni1, A. Castro1, M.L. Loricchio1, M. Mercurio1, F. Messina1, G. Altamura1, 1Sandro Pertini Hospital,CESC, UOC Cardiologia ­ Rome ­ Italy,

Topic(s):Tools: catheters, sources, mapping, navigators (Catheter ablation /except atrial

Citation: Europace Abstracts Supplement ( 2015 ) 17 ( Supplement 3 ), iii188

Electrical storm (ES)radiofrequency ablation (RFA) may involve complex anatomic structures or lead to fasthemodynamic destabilization and major complications (MC) . Intracardiac Echocardiographic approach (ICE)may speed detailed and complex 3D reconstruction and monitor complications. We retrospectively comparedICE and standard contact mapping (SCM) impact on ES ablation.

19 ES pts (11 males, 9 ICE, 67 ± 6 y) underwent RFA from 2010 to 2015. We compared ICE to SCM interms of VT inducibility, procedural and fluoroscopy time and complications.

6 (60%) of SCM and 6 (66,7%) of ICE pts achieved complete VT noninducibility. ICE allowed pedunculatedaneurysm, false tendons, moderator band and sinotubular junction plaque (leading to switch from retrograde totranseptal approach) visualization in 4 cases; increasing pericardial effusion with fibrin apposition in 1 (controlledby heparin neutralization). procedural and fluoroscopy times were shorter in ICE. No MC happened in bothgroups.

ICE may increase ES ablation effectiveness, decrease procedure duration and fluoroscopy time. ICE alloweddirect visualization and management of complex and risky anatomies and impending MC.

Table 1

SCM (10) ICE (9)

Males 6 (60%) 6 (66,7%)

Ischemic 6 (60%) 6 (66,7%)

Idiopathic 2 (20%) 2 (22,2%)

Myocarditis 0 1 (11,1%)

Dilated 2 (20%) 0

EF 34 ± 4% 41 ±6%

Transeptal approach 4 (40%) 4 (44,4%)

Negative PES 6 (60%) 6 (66,7%)

Complex/Risky anatomy ­ 4 (44,4%)

Fluoro / Procedural time 48 ± 25/248 ± 36 min 28 ± 20/201 ± 22min

Increasing Pericardial effusion 0 1 (11,1%)