scholarly journals Performance and Safety of Temperature- and Flow-Controlled Radiofrequency Ablation in Ablation Index–Guided Pulmonary Vein Isolation

2021 ◽  
Vol 7 (3) ◽  
pp. 408-409
Author(s):  
Alexandre Almorad ◽  
Jean-Yves Wielandts ◽  
Milad El Haddad ◽  
Sébastien Knecht ◽  
René Tavernier ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Ablation Index

A multicentered evaluation of ablation at higher power guided by ablation index: Establishing ablation targets for pulmonary vein isolation

2019 ◽  
Vol 30 (3) ◽  
pp. 357-365 ◽  
Author(s):  
Gurpreet Dhillon ◽  
Syed Ahsan ◽  
Shohreh Honarbakhsh ◽  
Wei Lim ◽  
Marco Baca ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Ablation Index ◽  
Higher Power

scholarly journals Myocardial injury after pulmonary vein isolation: fire versus ice

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A R Morgado Gomes ◽  
N S C Antonio ◽  
S Silva ◽  
M Madeira ◽  
P Sousa ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Troponin I ◽  
Surrogate Marker ◽  
High Sensitivity ◽  
Cryoballoon Ablation ◽  
Single Shot ◽  
High Sensitivity Troponin ◽  
Ablation Index ◽  
Significant Difference

Abstract Introduction The cornerstone of atrial fibrillation (AF) catheter ablation is pulmonary vein isolation (PVI), either using point-by-point radiofrequency ablation (RF) or single-shot ablation devices, such as cryoballoon ablation (CB). However, achieving permanent transmural lesions is difficult and pulmonary vein (PV) reconnection is common. Elevation of high-sensitivity Troponin I (hsTnI) may be used as a surrogate marker for transmural lesions. Still, data regarding the comparison of hsTnI increase after PVI with RF or cryo-energy is controversial. Purpose The aim of this study is to compare the magnitude of hsTnI elevation after PVI with CB versus RF using ablation index guidance. Methods Prospective study of 60 patients admitted for first ablation procedure of paroxysmal or persistent AF in a single tertiary Cardiology Department. Thirty patients were submitted to PVI using CB and 30 patients were submitted to RF, using CARTO® mapping system and ablation index guidance. Patients with atrial flutter were excluded. Baseline characteristics were compared between groups, as well as hsTnI before and after the procedure. Results Mean age was 57.9±12.3 years old, 62% of patients were male and 77% had paroxysmal AF. There were no significant differences between groups regarding gender, age, prevalence of hypertension, dyslipidaemia, diabetes, obesity or AF type. There was also no significant difference in electrical cardioversion need during the procedure. HsTnI median value before ablation was 1.90±1.98 ng/dL. Postprocedural hsTnI was significantly higher in CB-group (6562.7±4756.2 ng/dL versus 1564.3±830.7 ng/dL in RF-group; P=0.001). Regarding periprocedural complications, there was only one case of mild pericardial effusion in RF-group associated with postablation hsTnI of 1180.0 ng/dL. Conclusions High-sensitivity Troponin I was significantly elevated after PVI, irrespective of the ablation technique. In CB-group, hsTnI elevation was significantly higher than in RF-group. This disparity may reflect more extensive lesions with cryoablation, without compromising safety. Longterm studies are needed to understand whether this hsTnI elevation is predictive of a lower AF recurrence rate. FUNDunding Acknowledgement Type of funding sources: None.

Postprocedural LGE-CMR comparison of laser and radiofrequency ablation lesions after pulmonary vein isolation

2018 ◽  
Vol 29 (8) ◽  
pp. 1065-1072 ◽  
Author(s):  
Rosa M. Figueras i Ventura ◽  
Andrei D. Mǎrgulescu ◽  
Eva M. Benito ◽  
Francisco Alarcón ◽  
Norihiro Enomoto ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Lge Cmr

scholarly journals Pulmonary vein encirclement using an Ablation Index-guided point-by-point workflow: cardiovascular magnetic resonance assessment of left atrial scar formation

EP Europace ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. 1817-1823 ◽  
Author(s):  
Louisa O’Neill ◽  
Rashed Karim ◽  
Rahul K Mukherjee ◽  
John Whitaker ◽  
Iain Sim ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Point Group ◽  
Scar Formation ◽  
Scar Burden ◽  
Ablation Index ◽  
Scar Width

Abstract Aims  A point-by-point workflow for pulmonary vein isolation (PVI) targeting pre-defined Ablation Index values (a composite of contact force, time, and power) and minimizing interlesion distance may optimize the creation of contiguous ablation lesions whilst minimizing scar formation. We aimed to compare ablation scar formation in patients undergoing PVI using this workflow to patients undergoing a continuous catheter drag workflow. Methods and results Post-ablation cardiovascular magnetic resonance imaging was performed in patients undergoing 1st-time PVI using a parameter-guided point-by-point workflow (n = 26). Total left atrial scar burden and the width and continuity of the pulmonary vein encirclement were determined on analysis of atrial late gadolinium enhancement sequences. Comparison was made with a cohort of patients (n = 20) undergoing PVI using continuous drag lesions. Mean post-ablation scar burden and scar width were significantly lower in the point-by-point group than in the control group (6.6 ± 6.8% vs. 9.6 ± 5.0%, P = 0.03 and 7.9 ± 3.6 mm vs. 10.7 ± 2.3 mm, P = 0.003). More complete bilateral pulmonary vein encirclements were seen in the point-by-point group (P = 0.038). All patients achieved acute PVI. Conclusion Pulmonary vein isolation using a point-by-point workflow is feasible and results in a lower scar burden and scar width with more complete pulmonary vein encirclements than a conventional drag lesion approach.

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