Correlation of UniPolar Electrogram modification with Ablation Index
during Atrial Fibrillation ablation: a pilot study ( COUPE–AF)
Abstract
Introduction Pulmonary vein isolation using radiofrequency catheter
ablation is the standard of care for patients with drug-refractory
atrial fibrillation. The purpose of this pilot study was to examine the
local unipolar electrogram (UEGM) modification characteristics of the
different target areas of left atrium and the associated ablation index
parameters during pulmonary vein isolation procedure. Methods The study
analyzed ten patients who underwent pulmonary vein isolation using
radiofrequency energy at our Centre in 2021. The local
electrophysiological properties and ablation parameters of 15 designated
areas of interest in the left atria targeted by radiofrequency catheter
ablation were collected. Results Out of the ten patients, six were men
(mean age 66 years) and the majority (n=8) had paroxysmal atrial
fibrillation. UEGM modification was observed in every studied RF
ablation lesion. The mean time to achieve the UEGM modification in the
posterior wall was shorter than that of the anterior wall( 8.9 seconds
vs 11.1 seconds, respectively). The time to achieve the UEGM
modification for every target was significantly shorter than delivered (
p<.001). Conclusion This study demonstrated that during
pulmonary vein isolation using radiofrequency energy, local UEGM
modification, representing a real-time surrogate of transmural lesion
creation, is achieved in significantly shorter time reaching the
conventional Ablation Index-guided approach in current practice.