Safety and efficacy of atrial fibrillation ablation guided by Ablation Index module

  • Francesco Solimene
  • Vincenzo Schillaci
  • Gergana Shopova
  • Francesco Urraro
  • Alberto Arestia
  • Assunta Iuliano
  • Fabio Maresca
  • Alessia Agresta
  • Vincenzo La Rocca
  • Antonio De Simone
  • Giuseppe StabileEmail author



Reconnection of pulmonary veins (PVs) remains common following radiofrequency catheter ablation for atrial fibrillation (AF). Ablation Index (AI) is a novel ablation quality marker that incorporates stability, contact force (CF), time, and power in a weighted formula. Its use seems to improve lesion durability. This is a prospective, single-arm registry to investigate on the safety and mid-term efficacy of AF ablation guided by the AI.


One hundred fifty-six consecutive patients (mean age 58 ± 10 years, 49% males, 44% with structural heart disease) referred for paroxysmal (124) or persistent (32) AF underwent antral PV isolation using a surround flow CF-sensing catheter guided by the AI. Radiofrequency was delivered targeting interlesion distance ≤ 6 mm and Ablation Index of 330–350 at posterior wall and 400–450 at anterior wall.


Mean overall procedure time was 95 ± 30 min with a mean fluoroscopy time of 5 ± 6 min. Mean ablation time was 26 ± 10 min, 627/628 targeted PV were isolated. One pericardial effusion and two groin hematomas were reported; none required intervention. During a mean follow-up of 14 ± 6 months, 17 (10.8%) (9% paroxysmal AF vs 22% persistent AF, p = 0.09) patients had an atrial arrhythmia recurrence.


PV ablation guided by AI resulted feasible, achieving a high rate of isolated PVs, with a low complication rate, and allowed a high single-procedure arrhythmia-free survival at 14 months.


Atrial fibrillation Catheter ablation Contact force Ablation Index Safety Mid-term outcome 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the institutional review committees, and all patients signed informed consents.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Francesco Solimene
    • 1
  • Vincenzo Schillaci
    • 1
  • Gergana Shopova
    • 1
  • Francesco Urraro
    • 1
  • Alberto Arestia
    • 1
  • Assunta Iuliano
    • 2
  • Fabio Maresca
    • 2
  • Alessia Agresta
    • 2
  • Vincenzo La Rocca
    • 3
  • Antonio De Simone
    • 3
  • Giuseppe Stabile
    • 2
    Email author
  1. 1.Clinica MontevergineMercoglianoItaly
  2. 2.Clinica MediterraneaNaplesItaly
  3. 3.Clinica San MicheleMaddaloniItaly

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