scholarly journals 1160Early experience with ablation index-guided pulmonary vein isolation compared with force-time integral-guided ablation using surround flow catheter tip irrigation for ablation of atrial fibrillation

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii246-iii246
Author(s):  
V. Weberndoerfer ◽  
S. Toggweiler ◽  
T. Schefer ◽  
I. Russi ◽  
M. Brinkert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Time Integral ◽  
Ablation Index ◽  
Catheter Tip ◽  
Force Time ◽  
Force Time Integral

scholarly journals Low contact force and force-time integral predict early recovery and dormant conduction revealed by adenosine after pulmonary vein isolation

EP Europace ◽  
2015 ◽  
Vol 17 (6) ◽  
pp. 877-883 ◽  
Author(s):  
J.-B. le Polain de Waroux ◽  
R. Weerasooriya ◽  
K. Anvardeen ◽  
C. Barbraud ◽  
S. Marchandise ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Contact Force ◽  
Early Recovery ◽  
Time Integral ◽  
Dormant Conduction ◽  
Force Time ◽  
Force Time Integral

scholarly journals Ablation Index for Catheter Ablation of Atrial Fibrillation　― Clinical Applicability and Comparison With Force-Time Integral ―

2018 ◽  
Vol 82 (11) ◽  
pp. 2722-2727 ◽  
Author(s):  
Paula Münkler ◽  
Stefan Kröger ◽  
Spyridon Liosis ◽  
Amr Abdin ◽  
Evgeny Lyan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Time Integral ◽  
Clinical Applicability ◽  
Ablation Index ◽  
Force Time ◽  
Force Time Integral

666Impact of local left atrial wall thickness on the incidence of acute pulmonary vein reconnection after ablation index-guided ablation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M J Mulder ◽  
M J B Kemme ◽  
L H G A Hopman ◽  
H A Hauer ◽  
G J M Tahapary ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Wall Thickness ◽  
Left Atrial ◽  
Atrial Wall ◽  
Time Integral ◽  
Left Atrial Wall ◽  
Ablation Index ◽  
Force Time ◽  
Pulmonary Vein Reconnection ◽  
Force Time Integral

Abstract Background/Introduction Pulmonary vein reconnection is considered a major determinant of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Ablation Index (AI)-guided ablation allows for the creation of ablation lesions of consistent depth and may reduce the incidence of pulmonary vein reconnection after PVI. However, anatomical and imaging studies have demonstrated an important inter- and intra-patient variability of left atrial wall thickness, which can result in non-transmural ablation lesion formation in thicker segments. Purpose The present study aimed to investigate the impact of local left atrial wall thickness on the incidence of acute pulmonary vein reconnection after AI-guided AF ablation. Methods Consecutive AF patients who underwent cardiac computed tomography (CT) imaging prior to AI-guided ablation between December 2017 and September 2019 were studied. AI targets were 500 for anterior/roof and 380 for posterior/inferior segments with a maximum interlesion distance of 6 mm. Occurrence of acute pulmonary vein reconnection after initial PVI was assessed after a 30-minute waiting period. Ablation procedures were analysed offline to determine minimum AI, force-time integral, contact force, ablation duration, power, impedance drop and maximum interlesion distance for each segment according to a 16-segment model. Pulmonary vein antrum wall thickness was assessed for each segment on reconstructed CT images based on patient-specific thresholds in Hounsfield Units, using a previously described method. Results Seventy patients (63% paroxysmal AF, 67% male, mean age 63 ± 8 years) who underwent preprocedural CT imaging and AI-guided AF ablation were studied. Acute reconnection (AR) occurred in 27/1152 segments (2%, 15 anterior/roof, 12 posterior/inferior) in 17/70 (24%) patients. Anterior/roof segments were thicker than posterior/inferior segments (1.48 [1.23-1.80] vs. 1.13 [1.00-1.30] mm; p < 0.01). Reconnected segments were characterised by a greater local atrial wall thickness, both in anterior/roof (1.83 [1.60-2.00] vs. 1.47 [1.20-1.80] mm; p < 0.01) and posterior/inferior (1.38 [1.25-1.50] vs. 1.13 [1.00-1.27] mm; p < 0.01) segments (Figure 1). Minimum AI, force-time integral, contact force, ablation duration, power, impedance drop and maximum interlesion distance were not associated with acute pulmonary vein reconnection. Conclusion Local atrial wall thickness is associated with acute pulmonary vein reconnection after AI-guided PVI. Individualised AI targets based on local wall thickness may be of use to create transmural ablation lesions and prevent pulmonary vein reconnection after PVI. Abstract Figure. Impact of wall thickness on reconnection

scholarly journals The role of ablation index-guided pulmonary vein isolation in high-sensitivity TrThe role of ablation index-guided pulmonary vein isolation in high-sensitivoponin I and atrial fibrillation recurrence

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
D De Campos ◽  
L Puga ◽  
P Sousa ◽  
N Antonio ◽  
L Elvas
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Contact Force ◽  
High Sensitivity ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ablation Index

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Ablation Index (AI) software has been associated with better freedom from atrial arrhythmias after pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF). There is conflicting data regarding the relationship between high sensitivity cardiac Troponin I (Hs-cTnI) and arrhythmia recurrence. The objective was to evaluate the impact of AI on Hs-cTnI level and on ablation effectiveness quotient (AEQ) and to assess if these markers are predictors of arrhythmia recurrence.  Methods Prospective observational study of consecutive patients referred for PVI for paroxysmal AF ablation from October 2017 to June 2018 according to a pre-specified AI protocol. Procedural endpoints and 2-year follow-up outcomes were assessed and compared to a retrospective cohort of conventional PVI contact-force-guided group .  Results A total of 56 patients were included: 29 patients the AI group and 27 patients in the control group. The mean age was 60.5 ± 10.3 years, 48% males. Left ventricular ejection fraction (60 ± 6 % AI vs 61 ± 5 % control, P = 0.07) and left atrium diameter (43 ± 7 mm AI vs 44 ± 6 mm control, P = 0.58) were comparable between groups. First-pass isolation was shown to be higher in the AI group (79% AI vs 44%, p= 0.01). Mean number of radiofrequency applications was lower in the AI group (93 ± 24 vs 111 ± 30, P = 0.02). Average contact-force was similar between groups (17.6 ± 4.1 g vs 22.6 ± 10.7 g, P =0.166). Patients that performed PVI guided by the AI had lower Hs-cTnI (1815 ± 1146 ng/L vs 3274 ± 1696 ng/L, p < 0.001) and lower AEQ (1.01 ± 0.7 ng/L/s vs 1.51 ± 0.7 ng/L/s, P = 0.011) compared to patients in the control group. During a mean follow-up of 26 ± 11 months, AF recurrence was documented in 10.3% of patients in the AI group and 22.2% in the control group (P = 0.223). Neither Hs-cTnI nor AEQ levels were predictors of arrhythmia recurrence.  Conclusions These data suggest that AI-guided catheter ablation is associated with reduced levels of of Hs-cTnI and AEQ. Neither Hs-cTnI and AEQ should be used to predict arrhythmia recurrence. Abstract Figure.

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