Chair: Devi Nair (Jonesboro, US)

Case Operator: Devi Nair (Jonesboro, US)

Panel: Amin Al-Ahmad (Austin, US); Kevin Makati (Tampa, US); Robert Percell (Lincoln, US); Walid Saliba (Cleveland, US)

This symposium is supported by Siemens Healthineers

Agenda

• 01:21: Welcome Remarks and Panel Introductions – Dr Devi Nair

• 03:42: Introduction to 4D ICE Imaging and AcuNav Lumos – Dr Kevin Makati

• 08:59: Case Presentation Part 1 - Transeptal Puncture, PVI and PFA Contact Guided by 4D ICE – Dr Devi Nair

• 20:24: Pros and Cons of a Concomitant Procedure – Dr Walid Saliba

• 27:38: Case Presentation Part 2 – PFA, CT Measurements, Sheath Exchange – Dr Devi Nair

• 48:17: 4D ICE Views for LAAC – Dr Amin Al-Ahmad

• 52:58: Case Presentation Part 3 – LAAC – Dr Devi Nair

• 01:00:43: Panel Discussion – All

Chaired and operated by Devi Nair (Jonesboro, US), this symposium featured Amin Al-Ahmad (Austin, US), Kevin Makati (Tampa, US), Robert Percell (Lincoln, US), and Walid Saliba (Cleveland, US), focusing on 4D ICE imaging with AcuNav Lumos for pulsed field ablation (PFA) and left atrial appendage closure (LAAC). Dr Makati introduced 4D ICE technology, highlighting its advantages in real-time anatomical visualisation and procedural efficiency. Dr Nair presented a step-by-step case demonstrating PFA and LAAC using 4D ICE, showcasing contact assessment, lesion overlap, and imaging-guided sheath navigation.

Dr Saliba discussed the pros and cons of concomitant procedures, addressing workflow efficiency, reimbursement, and anatomical considerations when combining PFA and LAAC. Dr Al-Ahmad reviewed optimised 4D ICE views for LAAC, demonstrating how minimal catheter manipulation improves device positioning and leak detection. The panel agreed that 4D ICE enhances procedural accuracy and may reduce reliance on transoesophageal echocardiography (TEE), though training and cost remain barriers to widespread adoption.