The role of echocardiography before and after catheter ablation for atrial fibrillation

Catheter ablation has become a routine method in treatment of atrial fibrillation. Echocardigraphy represents an essential imaging method in cardiology, without which complex ablation procedures could not be performed safely. Obtaining information on structural condition of the heart, and ruling out the presence of an atrial thrombus are the primary aims of echocardiography prior to the ablation. During the ablation procedure, echocardiography remains the mainstay of exclusion of immediate and gradually evolving complications like bleeding into pericardium and pulmonary vein stenosis. There is an increasing role of echocardiography in assessment of morphology and function of the left atrium after ablation. Particularly, evaluation of the left atrial appendage flow velocity as an indicator of its preserved, respectively improved mechanical function after successful ablation appears to be a significant element of the decision, whether or not the lifelong anticoagulation therapy can be discontinued after ablation. Use of intracardiac echocardiography has been recently spreading out to help to navigate transseptal puncture, image anatomical structures, and to reveal early procedure-related complications.

Keywords: atrial fibrillation, catheter ablation, echocardiography