Ablation Energy Sources: Principles and Utility in Ablation Without Fluoroscopy

The development of ablation energy sources has allowed for catheter-based therapy of various arrhythmic substrates. Each energy source differs in its physiology of lesion formation as well as its relative advantages and disadvantages when harnessed for reduced-fluoroscopy ablation. Commonly used and alternative ablation energy sources are surveyed here. Specific considerations when these energy sources are utilized in low- and zero-fluoroscopy scenarios are addressed, and potential strategies that may be employed are outlined.