Milagros Mallma-Gomez, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Diego Davila-Flores, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Renee Montesinos-Segura, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Mario Cabrera-Saldaña, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Richard Soto-Becerra, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Carolina Guevara-Caicedo, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Pío Zelaya-Castro, Servicio de Electrofisiología, Instituto Nacional Cardiovascular, INCOR, EsSalud, Lima, Perú
Background: Intracardiac echocardiography (ICE) allows real-time visualization of catheters, cardiac structures and radiofrequency lesions, and reduces periprocedural complications. Objective: To characterize the clinical features, procedural outcomes, and complications of catheter ablation for complex cardiac arrhythmias guided by ICE at the Instituto Nacional Cardiovascular (INCOR). Method: This descriptive, and retrospective study included patients ≥ 14 years who underwent catheter ablation for a complex cardiac arrhythmia guided by ICE at INCOR-Peru, between 2021 and 2023. Clinical variables, arrhythmia types, and procedural characteristics were described. Results: 44 patients were included, median age was 51 years, 72.7% were male, 22.6% had structural heart disease, with 13.6% being congenital. 18.8% had an intracardiac device and 47.7% had a history of ablation. The most frequent arrhythmias were atrial fibrillation and ventricular extrasystoles (18.2% each). Mean procedure duration 199.2 minutes, mean fluoroscopy time 10.3 minutes, and mean radiation dose 272 mGy. Ablation success was 88.6%, significant complications in 4.5%, mainly cardiac tamponade, and minor complications in 6.8%. Conclusions: Catheter ablation of complex cardiac arrhythmias using ICE achieved an 88.6% success rate and a 4.5% rate of major complications. These results support the efficacy and safety of EIC-guided ablation, improving the management of complex arrhythmias.
Keywords: Intracardiac echocardiography. Arrhythmia ablation. Periprocedural complications.