scholarly journals Factors associated with the efficacy of atrial fibrillation radiofrequency catheter ablation: opinion of the specialists who use the “Ablation Index” module

2021 ◽  
Vol 28 ◽  
pp. 3-16
Author(s):  
E. N. Mikhaylov ◽  
N. Z. Gasimova ◽  
S. A. Ayvazyan ◽  
E. A. Artyukhina ◽  
G. A. Gromyko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Efficacy And Safety ◽  
Web Based ◽  
Electronic Survey ◽  
Factors Associated ◽  
Ablation Index

This document provides an overview of current problems and trends in the catheter ablation of atrial fibrillation, summarizes the opinions of specialists, obtained during a web-based electronic  survey, on aspects and parameters of radiofrequency ablation. The  approaches on improving the efficacy and safety of radiofrequency  catheter ablation of atrial fibrillation are provided. 

scholarly journals Factors associated with the efficacy of atrial fibrillation radiofrequency catheter ablation: opinion of the specialists who use the “ablation index” module

2020 ◽  
Vol 27 (3) ◽  
pp. 9-24
Author(s):  
E. N. Mikhaylov ◽  
N. Z. Gasimova ◽  
S. A. Ayvazyan ◽  
E. A. Artyukhina ◽  
G. A. Gromyko ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Efficacy And Safety ◽  
Web Based ◽  
Electronic Survey ◽  
Factors Associated ◽  
Ablation Index

This document provides an overview of current problems and trends in the catheter ablation of atrial fibrillation, summarizes the opinions of specialists, obtained during a web-based electronic survey, on aspects and parameters of radiofrequency ablation. The approaches on improving the efficacy and safety of radiofrequency catheter ablation of atrial fibrillation are provided.

scholarly journals EFFICIENCY AND SAFETY OF RADIOFREQUENCY CATHETER ABLATION OF ATRIAL FIBRILLATION IN ELDERLY PATIENTS

2017 ◽  
Vol 8 (2) ◽  
pp. 34-41
Author(s):  
M H Fedorova ◽  
A V Chapurnykh ◽  
V B Nizhnichenko ◽  
S V Lakomkin ◽  
V L Doshicin
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Elderly Patients ◽  
Radiofrequency Catheter Ablation ◽  
Risk Of Death ◽  
Group A ◽  
People Group ◽  
Methods Of Treatment

Atrial fibrillation is one of the most frequent and significant rhythm disturbances. The effectiveness and expediency of using one of the most effective methods of treatment of this arrhythmia (radiofrequency ablation in elderly patients) remains a controversial and insufficiently studied issue. The article compares the results of the treatment of 63 patients of mature age (up to 75 years) and senile age (from 75 years). Patients underwent 78 operations of radiofrequency catheter ablation of atrial fibrillation and atypical atrial flutter, which was resistant to drug therapy. In the groups of patients of mature and senile age, there were no statistically significant differences in the effectiveness of treatment. In elderly people group, a higher incidence of complications was found mainly due to hydrothorax, but these complications did not increase the risk of death and were stopped during treatment. This allows to conclude that the senile age of patients should not be the reason for refusing to conduct radiofrequency catheter ablation.

Clinical efficacy and safety of radiofrequency catheter ablation for atrial fibrillation in patients aged ≥80 years

2020 ◽  
Vol 43 (8) ◽  
pp. 814-821 ◽  
Author(s):  
Genqing Zhou ◽  
Lidong Cai ◽  
Xiaoyu Wu ◽  
Liangfeng Zhang ◽  
Songwen Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Clinical Efficacy ◽  
Radiofrequency Catheter Ablation ◽  
Efficacy And Safety

scholarly journals Efficacy and safety of ablation index-guided catheter ablation for atrial fibrillation: an updated meta-analysis

EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1659-1671
Author(s):  
Adam Ioannou ◽  
Nikolaos Papageorgiou ◽  
Wei Yao Lim ◽  
Tanakal Wongwarawipat ◽  
Ross J Hunter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Ablation Index ◽  
Procedural Time ◽  
Force Time ◽  
European Society Of Cardiology ◽  
Procedural Outcomes

Abstract Aims  Despite recent advances in catheter ablation for atrial fibrillation (AF), pulmonary vein reconnection (PVR), and AF recurrence remain significantly high. Ablation index (AI) is a new method incorporating contact force, time, and power that should optimize procedural outcomes. We aimed to evaluate the efficacy and safety of AI-guided catheter ablation compared to a non-AI-guided approach. Methods and results  A systematic search was performed on MEDLINE (via PubMED), EMBASE, COCHRANE, and European Society of Cardiology (ESC) databases (from inception to 1 July 2019). We included only studies that compared AI-guided with non-AI-guided catheter ablation of AF. Eleven studies reporting on 2306 patients were identified. Median follow-up period was 12 months. Ablation index-guided ablation had a significant shorter procedural time (141.0 vs. 152.8 min, P = 0.01; I2 = 90%), ablation time (21.8 vs. 32.0 min, P < 0.00001; I2 = 0%), achieved first-pass isolation more frequently [odds ratio (OR) = 0.09, 95%CI 0.04–0.21; 93.4% vs. 62.9%, P < 0.001; I2 = 58%] and was less frequently associated with acute PVR (OR = 0.37, 95%CI 0.18–0.75; 18.0% vs 35.0%; P = 0.006; I2 = 0%). Importantly, atrial arrhythmia relapse post-blanking was significantly lower in AI compared to non-AI catheter ablation (OR = 0.41, 95%CI 0.25–0.66; 11.8% vs. 24.9%, P = 0.0003; I2 = 35%). Finally, there was no difference in complication rate between AI and non-AI ablation, with the number of cardiac tamponade events in the AI group less being numerically lower (OR = 0.69, 95%CI 0.30–1.60, 1.6% vs. 2.5%, P = 0.39; I2 = 0%). Conclusions  These data suggest that AI-guided catheter ablation is associated with increased efficacy of AF ablation, while preserving a comparable safety profile to non-AI catheter ablation.

scholarly journals Optimal ablation index parameters for radiofrequency ablation therapy of atrial fibrillation

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Xiaoru Qin ◽  
Xiaofei Jiang ◽  
Qiyan Yuan ◽  
Guangli Xu ◽  
Xianzhi He
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Paroxysmal Atrial Fibrillation ◽  
Posterior Wall ◽  
Control Group ◽  
Ablation Therapy ◽  
Ablation Index ◽  
Gastrointestinal Discomfort ◽  
Radiofrequency Ablation Therapy

Objective: To explore the optimal ablation index (AI) parameters for radiofrequency catheter ablation (RA) for treating atrial fibrillation (AF). Method: Patients with AF (186) who underwent bilateral PVAI in the Department of Cardiology, Zhuhai People’s Hospital, Guangdong Province, from March 2018 to October 2019 and received catheter ablation as first-round treatment, were grouped according to the received AI. Control group included patients (95) who received the recommended AI ablation (350–400 for posterior wall, 400–450 for non-posterior wall). Patients in optimal AI group were ablated with optimal AI (300–330 for posterior wall, 350–380 for non-posterior wall). Results: Of 186 patients, 66 patients had paroxysmal atrial fibrillation and a mean CHA2DS2-VASc score of 2.83±1.64. Isolation rates of bilateral PVI in both groups were 91.4% and 93.6%, for patients with paroxysmal atrial fibrillation, and 81.7% and 80% for patients with persistent atrial fibrillation (P > 0.05). Left atrial function index (LAFI) decreased under the condition of sinus rhythm at the 3rd and 6th months (P < 0.05). LAFI improvement was significantly better in the optimal AI group than in the control group (P < 0.05). Rates of pain and cough during the ablation, and postoperative gastrointestinal discomfort and use of PPIs were higher in the control group (P < 0.05). Conclusion: Radiofrequency ablation of AF, guided by optimal AI combined with impedance, can minimize atrial injury, prevent atrial failure, promote the recovery of atrial function, reduces intraoperative cough, pain, and postoperative gastrointestinal discomfort and use of PPIs. doi: https://doi.org/10.12669/pjms.38.3.4971 How to cite this:Qin X, Jiang X, Yuan Q, Xu G, He X. Optimal ablation index parameters for radiofrequency ablation therapy of atrial fibrillation. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4971 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Association between ablation index and myocardial injury following radiofrequency catheter ablation for atrial fibrillation

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A De Bortoli ◽  
O-G Anfinsen ◽  
T Holm
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Myocardial Injury ◽  
Troponin T ◽  
Lesion Size ◽  
Limiting Factor ◽  
Af Ablation ◽  
Ablation Index ◽  
Target Values

Abstract Funding Acknowledgements Type of funding sources: None. Background  Unpredictable lesion formation is a major limiting factor for radiofrequency catheter ablation for atrial fibrillation (AF). Ablation index (AI) emerged as a novel parameter to monitor lesion development and potentially improve clinical outcomes. Additional evidence is needed to support its use. Purpose  We aimed at evaluating the relationship between AI and other lesion indicators and the release of myocardial-specific biomarkers following AF ablation. Methods  Forty-six patients with similar baseline characteristics underwent a first-time radiofrequency ablation for AF and were prospectively enrolled in this study. Pulmonary vein isolation was performed by six experienced electrophysiologists with a point-by-point approach, guided by strict Visitag criteria and consistent AI target values. Myocardial-specific biomarkers troponin T and creatine kinase myocardial band were measured after 6 (TnT6 and CKMB6) and 20 hours (TnT20 and CKMB20) following sheath removal. Ablation duration, impedance drop (ID), force-time integral (FTI) and AI were registered automatically and analyzed off-line. Since biomarkers release reflect the total amount of myocardial injury, our independent variables consisted of total ablation duration, total ID, total FTI and total AI.  Results  97% of total ablation duration fulfilled pre-specified Visitag criteria. Mean application duration was 20.0 ± 3.5 s, mean contact force was 15.9 ± 4.2 g, mean maximum power was 35.3 ± 1.5 W. Troponin T release was 985 ± 495 ng/L and 1038 ± 461 ng/L (p = ns) while CKMB release was 7.3 ± 2.7 mcg/L and 6.5 ± 2.1 mcg/L (p &lt; 0.001) at 6 and 20 hours, respectively. Ablation duration, ID, FTI and AI were all significantly correlated with the release of myocardial-specific biomarkers both at 6 and 20 hours (all correlations significant at p &lt; 0.01 level, Fig. 1). Ablation index showed the highest degree of correlation with TnT6, TnT20, CKMB6 and CKMB20 (Pearson`s R 0.69, 0.69, 0.58, 0.64 respectively, p &lt; 0.001). Multiple regression analysis demonstrated that AI had the strongest association with TnT6, TnT20, CKMB6 and CKMB20 (beta 0.43, 0.71, 0.41 and 0.43, respectively). Conclusion  Ablation index appears as the strongest lesion size indicator as measured by the release of myocardial-specific biomarkers following radiofrequency catheter ablation for AF. Abstract Figure. Scatter plots and correlations

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