Reproducibility of pulmonary vein isolation guided by the ablation index: One-year outcome of the AIR registry - 09/01/21
Résumé |
Background |
Arial fibrillation (AF) ablation outcome is still operator dependent. Ablation Index (AI) is a new lesion quality marker that has demonstrated to allow acute durable pulmonary vein (PV) isolation followed by a high single-procedure arrhythmia-free survival.
Aim |
This prospective, multi-centre study was designed to evaluate the reproducibility of 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 380–500). Radiofrequency energy was delivered targeting interlesion distance ≤6mm.
Results |
At 12 months’ follow-up a high rate of freedom from AF recurrences was observed in patients with both paroxysmal and persistent AF (91% vs. 83.3%, P=0.039). There was no difference in the rate of atrial arrhythmias recurrence among the four study groups (4.5% in Group ST330–450, 12.2% in Group ST 380–500, 14.9% in Group STSF330–450, 9.4% in Group STSF380–500, P=0.083). At 12 months’ follow-up, the rate of atrial arrhythmias recurrence was also similar between patients treated with a ST catheter (8%) and STSF catheter (12.1%, P=0.2), between patients treated with an AI settings of 330–450 (10.9%) and an AI of 380–500 (10.3%, P=0.64), and among the several operators (P=0.84 and P=0.75 respectively in patients with paroxysmal and persistent AF) (Fig. 1).
Conclusions |
An ablation protocol respecting strict criteria for contiguity and quality lesion resulted in high rate of one-year freedom from AF recurrence, both in patients with paroxysmal and persistent AF, irrespective of the ablation catheters, AI settings, and operator.
Le texte complet de cet article est disponible en PDF.Plan
Vol 13 - N° 1
P. 89-90 - janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.