Francesco Solimene1, Antoine Lepillier2, Ermenegildo De Ruvo3, Marco Scaglione4, Matteo Anselmino5, Frederic A Sebag6, Domenico Pecora7, Mark M Gallagher8, Mariano Rillo9, Graziana Viola10, Luca Rossi11, Valerio De Santis12, Maurizio Landolina13, Antonello Castro14, Massimo Grimaldi15, Nicolas Badenco16, Maurizio Del Greco17, Antonio De Simone18, Emanuele Bertaglia19, Giuseppe Stabile1,18. 1. Clinica Montevergine, Mercogliano, (AV), Italy. 2. Centre Cardiologique du Nord, St Denis, Paris, France. 3. Policlinico Casilino, Roma, Italy. 4. Ospedale Cardinal Massaia, Asti, Italy. 5. A.O.U. Citta della Salute e della Scienza di Torino, Italy. 6. Institut Mutualiste Montsouris, Paris, France. 7. Fondazione Poliambulanza, Brescia, Italy. 8. St George's Hospital, London, United Kingdom. 9. Casa di Cura Villa Verde, Taranto, Italy. 10. Ospedale San Francesco, Nuoro, Italy. 11. Ospedale Civili Guglielmo da Saliceto, Piacenza, Italy. 12. Istituto Clinico Sant' Ambrogio, Milano, Italy. 13. Ospedale Maggiore di Crema, Italy. 14. Ospedale Pertini, Roma, Italy. 15. Ospedale Regionale Miulli, Acquaviva delle Fonti, (BA), Italy. 16. Centre La Pitiè Salpetriere, Paris, France. 17. Ospedale S Maria Del Carmine, Rovereto, (TN), Italy. 18. Clinica San Michele, Maddaloni, (CE), Italy. 19. Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Italy.
Abstract
BACKGROUND: Atrial fibrillation (AF) ablation outcome is still operator dependent. Ablation Index (AI) is a new lesion quality marker that has been demonstrated to allow acute durable pulmonary vein (PV) isolation followed by a high single-procedure arrhythmia-free survival. This prospective, multicenter study was designed to evaluate the reproducibility of acute PV isolation guided by the AI. METHODS: A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV encircling and were divided in four study groups according to operator preference in choosing the ablation catheter (a contact force [ST] or contact force surround flow [STSF] catheter) and the AI setting (330 at posterior and 450 at anterior wall or 380 at posterior and 500 at anterior wall). Radiofrequency was delivered targeting interlesion distance ≤6 mm. RESULTS: The rate of first-pass PV isolation (ST330 90 ± 16%, ST380 87 ± 19%, STSF330 90 ± 17%, STSF380 91 ± 15%, P = .585) was similar among the four study groups, whereas procedure (ST330 129 ± 44 minutes, ST380 144 ± 44 minutes, STSF330 120 ± 72 minutes, STSF380 125 ± 73 minutes, P < .001) and fluoroscopy time (ST330 542 ± 285 seconds, ST380 540 ± 416 seconds, STSF330 257 ± 356 seconds, STSF380 379 ± 454 seconds, P < 0.001) significantly differed. The difference in the rate of first-pass isolation was not statistical different (P = .06) among the 12 operators that performed at least 15 procedures. CONCLUSIONS: An ablation protocol respecting strict criteria for contiguity and quality lesion results in high and comparable rate of acute PV isolation among operator performing ablation with different catheters, AI settings, procedure, and fluoroscopy times.
BACKGROUND:Atrial fibrillation (AF) ablation outcome is still operator dependent. Ablation Index (AI) is a new lesion quality marker that has been demonstrated to allow acute durable pulmonary vein (PV) isolation followed by a high single-procedure arrhythmia-free survival. This prospective, multicenter study was designed to evaluate the reproducibility of acute PV isolation guided by the AI. METHODS: A total of 490 consecutive patients with paroxysmal (80.4%) and persistent AF underwent first time PV encircling and were divided in four study groups according to operator preference in choosing the ablation catheter (a contact force [ST] or contact force surround flow [STSF] catheter) and the AI setting (330 at posterior and 450 at anterior wall or 380 at posterior and 500 at anterior wall). Radiofrequency was delivered targeting interlesion distance ≤6 mm. RESULTS: The rate of first-pass PV isolation (ST330 90 ± 16%, ST380 87 ± 19%, STSF330 90 ± 17%, STSF380 91 ± 15%, P = .585) was similar among the four study groups, whereas procedure (ST330 129 ± 44 minutes, ST380 144 ± 44 minutes, STSF330 120 ± 72 minutes, STSF380 125 ± 73 minutes, P < .001) and fluoroscopy time (ST330 542 ± 285 seconds, ST380 540 ± 416 seconds, STSF330 257 ± 356 seconds, STSF380 379 ± 454 seconds, P < 0.001) significantly differed. The difference in the rate of first-pass isolation was not statistical different (P = .06) among the 12 operators that performed at least 15 procedures. CONCLUSIONS: An ablation protocol respecting strict criteria for contiguity and quality lesion results in high and comparable rate of acute PV isolation among operator performing ablation with different catheters, AI settings, procedure, and fluoroscopy times.
Authors: Pedro A Sousa; Luís Puga; Luís Adão; João Primo; Ziad Khoueiry; Ana Lebreiro; Paulo Fonseca; Philippe Lagrange; Luís Elvas; Lino Gonçalves Journal: J Arrhythm Date: 2022-03-15
Authors: A Lepillier; T Strisciuglio; E De Ruvo; M Scaglione; M Anselmino; F A Sebag; D Pecora; M M Gallagher; M Rillo; G Viola; E Pisanò; S Abbey; F Lamberti; A Pani; G Zucchelli; G Sgarito; A De Simone; E Bertaglia; F Solimene; Giuseppe Stabile Journal: J Interv Card Electrophysiol Date: 2021-02-11 Impact factor: 1.900
Authors: Mark J Mulder; Michiel J B Kemme; Amaya M D Hagen; Luuk H G A Hopman; Peter M van de Ven; Herbert A Hauer; Giovanni J M Tahapary; Marco J W Götte; Albert C van Rossum; Cornelis P Allaart Journal: Int J Cardiol Heart Vasc Date: 2020-07-03