Pulmonary Vein Antrum Isolation:

Intracardiac Echocardiography-Guided Technique


  • J Cardiovasc Electrophysiol, Vol. 15, pp. 1-6, November 2004.

  • Editor: Hugh Calkins, M.D.

Andrea Natale, M.D., Cleveland Clinic Foundation, Desk F15, 9500 Euclid Avenue, Cleveland, OH 44195. Fax: 216-444-4428; E-mail: natalea@ccf.org


Several techniques are used for AF ablation, but no general consensus exists as to which technique is the most effective. At our center, we have developed a technique for isolating the pulmonary veins (PVs) at their antrum. The technique is guided by intracardiac echocardiography (ICE) and mapping with a circular (Lasso) catheter. Our technique was developed based on four crucial principles:

  • 1Precisely identifying the true border of the PV antrum
  • 2Electrically isolating all of the PVs at the level of the antrum
  • 3Avoiding risk of PV stenosis by ablating outside of the antrum
  • 4Minimizing risk of other complications, such as perforation and stroke, by direct visualization during transseptal access and radiofrequency (RF) ablation.