Antiarrhythmic Device Implantation Without the Use of Fluoroscopy Under the Intracardiac Echo Guidance

Aim of the study: To assess safety and effectiveness of anti arrhythmic device implantation (AAD) under the intracardiac echo guidance (ICE)

Methods and results: 80 patients were included in study. Mean age of patients was 53,4 + 9,1 years. All the patients signed informed consent and were blindly randomized into two groups. In the first group AAD was performed in a usual way by using fluoroscopy. In the second group AAD implantation was performed under the ICE guidance. Active fixation leads were implanted in all patients. Atrial lead was fixed in the right atrial appendage, ventricular lead was fixed in the right ventricle outflow tract (RVOT) in both groups. Procedure time in the first group was 76,2 + 24,3 min, in the second group 60,1 + 11,4 min. Pacing parameters were comparable in both groups and did not differ significantly. We did not reveal any major complications as well as we did not reveal any complications in groin in the second group. In early follow up period in the second group dislodgment of atrial lead was diagnosed and lead was repositioned the same day by using routine fluoroscopic approach. Time of in hospital stay did not differ significantly in both groups.

Conclusion: AAD implantation procedure under the ICE guidance is safe and effective and can be used to exclude fluoroscopy. Also this method can be used to prevent potential damage of tricuspid valve structures. Positioning of ventricle lead under the ICE guidance in RVOT and in RVA is safe and effective as well.