AIMS: To evaluate the clinical outcome of pulmonary vein isolation (PVI) in radiofrequency ablation of atrial fibrillation (AF) comparing a strategy using Ablation Index (AI) and lesion contiguity with Contact Force (CF) only. METHODS: In a single-center retrospective design, we included 479 patients with AF (n=341 (71.2%) paroxysmal AF (PAF) and n=138 (28.8%) persistent AF (PeAF)) treated with first time radiofrequency ablation. In 2015, 210 patients underwent PVI based on a drag-and-ablate technique using CF only. In 2017, 269 patients underwent point-by-point PVI using AI and a maximum inter-lesion distance of 6 mm ensuring contiguity. Follow-up was performed after 12 months. Outcome was freedom from documented AF/atrial tachycardia (AT) after single procedure without use of anti-arrhythmic drugs at follow-up. RESULTS: There was no significant difference in baseline characteristics between the groups. The median procedure time and mean ablation time were significantly longer in the AI-group compared to the CF-group (131.5[113;156] min vs. 120.0[97;140] min, P < 0.01) and (44.1±10.0 min vs. 37.1±13.3 min, P < 0.01), respectively. Freedom from documented AF/AT was significantly higher in the AI-group compared to the conventional CF -group (71.0% vs. 62.4%, P = 0.046). The improvement in clinical outcome in the AI group is mainly driven by the outcome in patients with PeAF (64.9% vs. 50.0%, P = 0.078) and not PAF. CONCLUSIONS: An ablation strategy combining AI and lesion contiguity improves the clinical outcome after first time PVI in patients with AF compared to a strategy using CF only.
AIMS: To evaluate the clinical outcome of pulmonary vein isolation (PVI) in radiofrequency ablation of atrial fibrillation (AF) comparing a strategy using Ablation Index (AI) and lesion contiguity with Contact Force (CF) only. METHODS: In a single-center retrospective design, we included 479 patients with AF (n=341 (71.2%) paroxysmal AF (PAF) and n=138 (28.8%) persistent AF (PeAF)) treated with first time radiofrequency ablation. In 2015, 210 patients underwent PVI based on a drag-and-ablate technique using CF only. In 2017, 269 patients underwent point-by-point PVI using AI and a maximum inter-lesion distance of 6 mm ensuring contiguity. Follow-up was performed after 12 months. Outcome was freedom from documented AF/atrial tachycardia (AT) after single procedure without use of anti-arrhythmic drugs at follow-up. RESULTS: There was no significant difference in baseline characteristics between the groups. The median procedure time and mean ablation time were significantly longer in the AI-group compared to the CF-group (131.5[113;156] min vs. 120.0[97;140] min, P < 0.01) and (44.1±10.0 min vs. 37.1±13.3 min, P < 0.01), respectively. Freedom from documented AF/AT was significantly higher in the AI-group compared to the conventional CF -group (71.0% vs. 62.4%, P = 0.046). The improvement in clinical outcome in the AI group is mainly driven by the outcome in patients with PeAF (64.9% vs. 50.0%, P = 0.078) and not PAF. CONCLUSIONS: An ablation strategy combining AI and lesion contiguity improves the clinical outcome after first time PVI in patients with AF compared to a strategy using CF only.
Authors: Thomas Phlips; Philippe Taghji; Milad El Haddad; Michael Wolf; Sébastien Knecht; Yves Vandekerckhove; René Tavernier; Mattias Duytschaever Journal: Europace Date: 2018-11-01 Impact factor: 5.214
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Authors: Laurent Macle; Paul Khairy; Rukshen Weerasooriya; Paul Novak; Atul Verma; Stephan Willems; Thomas Arentz; Isabel Deisenhofer; George Veenhuyzen; Christophe Scavée; Pierre Jaïs; Helmut Puererfellner; Sylvie Levesque; Jason G Andrade; Lena Rivard; Peter G Guerra; Marc Dubuc; Bernard Thibault; Mario Talajic; Denis Roy; Stanley Nattel Journal: Lancet Date: 2015-07-23 Impact factor: 79.321
Authors: Karl-Heinz Kuck; Boris A Hoffmann; Sabine Ernst; Karl Wegscheider; Andras Treszl; Andreas Metzner; Lars Eckardt; Thorsten Lewalter; Günter Breithardt; Stephan Willems Journal: Circ Arrhythm Electrophysiol Date: 2016-01
Authors: Josef Kautzner; Petr Neuzil; Hendrik Lambert; Petr Peichl; Jan Petru; Robert Cihak; Jan Skoda; Dan Wichterle; Erik Wissner; Aude Yulzari; Karl-Heinz Kuck Journal: Europace Date: 2015-06-03 Impact factor: 5.214