One-year outcome and durability of pulmonary vein isolation after prospective use of ablation index for catheter ablatio
- PDF / 568,557 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 83 Downloads / 186 Views
One-year outcome and durability of pulmonary vein isolation after prospective use of ablation index for catheter ablation in patients with persistent atrial fibrillation Nico Reinsch 1,2 & Anna Füting 1 & Jochen Buchholz 1 & Ute Ruprecht 1,2 & Volker Holzendorf 3 & Felix Buschmeier 1 & Hagen Kälsch 2,4 & Kars Neven 1,2 Received: 7 September 2019 / Accepted: 16 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Radiofrequency (RF) catheter ablation for persistent atrial fibrillation (peAF) is associated with less favorable outcomes than for paroxysmal AF (PAF). Recent studies have shown improved clinical outcomes with use of ablation index (AI) targets for pulmonary vein isolation (PVI) in PAF. AI is a novel ablation quality marker that incorporates contact force (CF), time, and power in a weighted formula. This is a single-arm registry to investigate the 1-year efficacy of AF ablation guided by the AI in patients with peAF, and further to evaluate pulmonary vein reconduction at repeat electrophysiology study in case of recurrent AF. Methods In total, 55 consecutive patients (69 ± 10 years, 55% male, median time since first AF diagnosis: 31 months (Q1–Q3: 10–70)) with peAF underwent AIguided PVI using a CF surround-flow catheter. AI targets were 600 for anterior and 450 for roof/posterior/inferior antral segments. Patients were monitored for atrial tachyarrhythmia recurrence using 5-day Holter-ECG recordings at 3, 6, and 12 months. Results The median procedure time was 173 min (Q1–Q3: 152–204). The median fluoroscopy time was 4 min (Q1–Q3: 3–6) and the median fluoroscopy dose was 2.64 Gy/cm2 (Q1–Q3: 1.04–3.99). The median ablation time was 57 min (Q1–Q3: 47–63). At 12 months, 42% of the patients were in sinus rhythm. AF recurrence was seen in 58% of patients. No major complications occurred. Conclusions RF ablation using AI in peAF is a feasible and safe technique. At 1 year, AI-guided ablation was associated with AF recurrence in 58% of the patients. Keywords Persistent atrial fibrillation . Ablation index . Catheter ablation . Pulmonary vein isolation
1 Introduction Atrial fibrillation (AF) is the most common arrhythmia causing significant morbidity and mortality [1]. In the last two decades, interventional treatment by catheter ablation has
* Nico Reinsch [email protected] 1
Department of Electrophysiology, Alfried Krupp Krankenhaus, Alfried-Krupp-Straße 21, 45131 Essen, Germany
2
University Witten/Herdecke, Witten, Germany
3
Clinical Trial Centre Leipzig - Coordination Centre for Clinical Trials (ZKS Leipzig - KKS), University Leipzig, Leipzig, Germany
4
Department of Cardiology, Alfried Krupp Krankenhaus, Essen, Germany
become one of the cornerstones in the management of patients with AF, with success rates that are substantially better than anti-arrhythmic drug treatment with regard to successful maintenance of sinus rhythm [2]. However, catheter ablation for persistent AF still is associated with less favorable outcome than for pa
Data Loading...
