Abstract 6943: Ablation Index-guided Pulmonary Vein Isolation Improve Performance and Safety of Treatment of Atrial Fibrillation

Abstract

Introduction: Pulmonary vein isolation (PVI) is a pivotal therapy for treatment of atrial fibrillation (AF), especially paroxysmal AF. Previous studies suggest that ablation index (AI) which integrated contact force (CF), time and power in a weighted formula improved success rate and safety of PVI. Hypothesis: Recently, our group has raised a novel protocol of AI-guided AF ablation according to different wall thickness of left atrium and compared the performance and safety of VisiTag ablation with or without this AI strategy. Methods: In this retrospectively study, AI parameters were set as 300-380U, 400-450U, 380-400U, 380-400U and 450-500U for posterior, anterior, inferior, roof and ridge respectively ( Figure 1 ). Radiofrequency energy was delivered at a maximum power output of 25-35 W depending on the ablation site (25-30W for the posterior aspects of the right and left PVs and 30-35 W for the anterior, inferior, Roof and ridge aspects). Results: No significant difference of patient characteristics was observed in VisiTag+AI group versus VisiTag group. One year after the procedure, the overall success rate was higher in VisiTag+AI group as compared to VisiTag group without differentiation of paroxysmal AF and persistent AF (95.1% vs. 83.3%, P=0.02). In subgroup analysis, the 1-year success rate in paroxysmal AF patients were 95.5% versus 82.5% in VisiTag+AI group versus VisiTag group (P=0.03), whereas the 1-year success rate in persistent AF patients were 93.3% versus 84.6% in VisiTag+AI group versus VisiTag group (P=0.40).Only one case of minor pericardial effusion without additional management was observed in VisiTag+AI group, whereas two cases of minor pericardial effusion and one case of pericardial tamponade were observed in VisiTag group during perioperative care. Conclusions: Improved performance and safety was observed in VisiTag ablation with this novel AI strategy in paroxysmal AF patients.