Ablation index guided pulmonary vein isolation can reduce early
recurrences of atrial tachyarrhythmias
Abstract
Introduction: 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 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 PVs during
second session between the two groups. ERAT was defined as any atrial
tachyarrhythmias ≥30 seconds during a 90-day blanking period. Results: A
total of 697 patients (paroxysmal 51%) were enrolled. After the PSM,
both groups included 229 patients. The incidence of ERAT was
significantly lower in AI group than CF group (21.5% vs. 36.1%,
P<0.001). The rate of PV reconnection was lower in AI group
than CF group (45.8% vs. 71.4%, P=0.028). Multivariate analysis
demonstrated that AI-guided PVI was independently correlated with the
incidence of ERAT (OR=0.415, 95%CI=0.269-0.639, P<0.001).
Conclusion: AI-guided PVI can reduce ERAT as compared to conventional
CF-guided PVI.