Atrial fibrillation (AF) is most common sustained arrhythmia in clinical practice. The new treatment standard in paroxysmal and persistent AF is the catheter ablation. Echocardiography plays a key role in risk stratification and management of patients with AF and is critical in the assessment of candidates for AF ablation, providing both anatomic and hemodynamic information. Echocardiography is crucial for patient selection, preprocedural left atrial appendage thrombus excluding, intraprocedural guidance, and detection and monitoring for early and late ablation related complications. Transthoracic echocardiography allows rapid and comprehensive assessment of cardiac anatomical structure and function. Transoesophageal echocardiography also provides accurate information about the presence of a thrombus in the atria and thromboembolic risk, making safe the ablation procedure by immediately detection of the complications related procedure. Intracardiac echocardiography has emerged as a popular and useful tool in the everyday practice of interventional electrophysiology, being very useful only during the ablation procedure. This paper presents the role of echocardiography in all these steps concerning AF ablation procedure, and also (1) delineates the role of echocardiographic techniques in guiding the procedure, (2) discusses the critical echocardiographic aspects of this procedure, and (3) underlines the strengths and limitations of various echocardiographic modalities.
Part of the book: Echocardiography in Heart Failure and Cardiac Electrophysiology