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

Journal of Interventional Cardiac Electrophysiology volume 54, pages 9–15 (2019)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Affiliations

  1. Clinica Montevergine, Via Mario Malzoni 5, 83013, Mercogliano, AV, Italy

    Francesco Solimene, Vincenzo Schillaci, Gergana Shopova, Francesco Urraro & Alberto Arestia

  2. Clinica Mediterranea, Via Orazio 2, 80122, Naples, Italy

    Assunta Iuliano, Fabio Maresca, Alessia Agresta & Giuseppe Stabile

  3. Clinica San Michele, Via Appia 187, 81024, Maddaloni, CE, Italy

    Vincenzo La Rocca & Antonio De Simone

Authors
  1. Francesco Solimene
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  2. Vincenzo Schillaci
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Correspondence to Giuseppe Stabile.

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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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Solimene, F., Schillaci, V., Shopova, G. et al. Safety and efficacy of atrial fibrillation ablation guided by Ablation Index module. J Interv Card Electrophysiol 54, 9–15 (2019). https://doi.org/10.1007/s10840-018-0420-5

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  • DOI: https://doi.org/10.1007/s10840-018-0420-5

Keywords

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