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Journal of Interventional Cardiac Electrophysiology

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21-10-2021 | Atrial Fibrillation

Ablation index–guided pulmonary vein isolation can reduce early recurrences of atrial tachyarrhythmias: a propensity score–matched analysis

Authors: Koji Yasumoto, Yasuyuki Egami, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Yutaka Matsuhiro, Masaki Tsuda, Naotaka Okamoto, Akihiro Tanaka, Yasuharu Matsunaga-Lee, Masamichi Yano, Ryu Shutta, Yasushi Sakata, Masami Nishino, Jun Tanouchi

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2022

Abstract

Purpose

Early recurrence of atrial tachyarrhythmias (ERAT) cause various symptoms and predict worse outcomes after pulmonary vein isolation (PVI). This study aimed to clarify whether ablation index (AI)–guided PVI, which is a novel technology of radiofrequency ablation, could reduce ERAT as compared to conventional contact force (CF)–guided PVI.

Methods

Consecutive atrial fibrillation (AF) patients who underwent initial PVI from September 2014 to August 2019 were enrolled. We divided the patients into two groups: patients who underwent AI-guided PVI (AI group) and those who underwent CF-guided PVI (CF group). Using propensity score matching (PSM), we adjusted for the patient backgrounds. We compared the incidence of ERAT and late reconnection rate of isolated pulmonary veins (PVs) during second session between the two groups. ERAT was defined as any atrial tachyarrhythmias ≥ 30 s during a 90-day blanking period.

Results

A total of 697 AF patients (paroxysmal 51%) were enrolled. After the PSM, both groups included 229 patients. The incidence of ERAT was significantly lower in the AI group than that in the CF group (21.5% vs. 36.1%, P < 0.001). Total 118 patients (25.7%) experienced late recurrence of atrial tachyarrhythmias (LRAT) after blanking period. LRAT free survival rate was significantly higher in patients without ERAT than those with ERAT (88.1% vs. 42.0%, P < 0.001). The rate of PV reconnection was lower in the AI group than that in the CF group (45.8% vs. 71.4%, P = 0.028). Multivariate analysis demonstrated that AI-guided PVI was independently correlated with ERAT (OR = 0.415, 95%CI = 0.269–0.639, P < 0.001).

Conclusions

AI-guided PVI can reduce ERAT as compared to conventional CF-guided PVI.

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22.

Title: Ablation index–guided pulmonary vein isolation can reduce early recurrences of atrial tachyarrhythmias: a propensity score–matched analysis
Authors: Koji Yasumoto
Yasuyuki Egami
Kohei Ukita
Akito Kawamura
Hitoshi Nakamura
Yutaka Matsuhiro
Masaki Tsuda
Naotaka Okamoto
Akihiro Tanaka
Yasuharu Matsunaga-Lee
Masamichi Yano
Ryu Shutta
Yasushi Sakata
Masami Nishino
Jun Tanouchi
Publication date: 21-10-2021
Publisher: Springer US
Keyword: Atrial Fibrillation
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 2/2022
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-021-01059-y

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Ablation index–guided pulmonary vein isolation can reduce early recurrences of atrial tachyarrhythmias: a propensity score–matched analysis

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

Purpose

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Results

Conclusions

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