Pulmonary vein antrum isolation: intracardiac echocardiography-guided technique.

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