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Tailored ablation index based on left atrial wall thickness assessed by computed tomography for pulmonary vein isolation in patients with atrial fibrillation

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Author(s)
So-Ryoung LeeHyoung-Seob ParkSoonil KwonEue-Keun ChoiSeil Oh
Keimyung Author(s)
Park, Hyoung Seob
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Cardiovasc Electrophysiol
Issued Date
2023
Volume
34
Issue
9
Keyword
ablation indexatrial fibrillationleft atrial wall thicknesspulmonary vein isolation
Abstract
Introduction:
Although left atrial wall thickness (LAWT) is known to be varied, a fixed target Ablation Index (AI) based pulmonary vein isolation (PVI) has been suggested in catheter ablation for atrial fibrillation (AF). We aimed to evaluate the efficacy and safety of PVI applying tailored AI based on LAWT assessed by cardiac computed tomography (CT).

Methods:
The thick segment was defined as the segment including ≥LAWT grade 3 (≥1.5 mm). The fixed AI strategy was defined as AI targets were 450 on the anterior/roof segments and 350 on the posterior/inferior/carina segments regardless of LAWT. The tailored AI strategy consisted of AI increasing the targets to 500 on the anterior/roof segments and to 400 on the posterior/inferior/carina segments when ablating the thick segment. After PVI, acute pulmonary vein (PV) reconnection, defined by the composite of residual potential and early reconnection, was evaluated.

Results:
A total of 156 patients (paroxysmal AF 72%) were consecutively included (86 for the fixed AI group and 70 for the tailored AI group). The tailored AI group showed a significantly lower rate of segments with acute PV reconnection than the fixed AI group (8% vs. 5%, p = .007). The tailored AI group showed a trend for shorter ablation time for PVI. One-year AF/atrial tachycardia free survival rate was similar in two groups (87.2% in the fixed AI group and 90.0% in the tailored AI group, p = .606).

Conclusion:
Applying tailored AI based on the LAWT was a feasible and effective strategy to reduce acute PV reconnection after PVI.
Keimyung Author(s)(Kor)
박형섭
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1540-8167
Source
https://onlinelibrary.wiley.com/doi/10.1111/jce.16026
DOI
10.1111/jce.16026
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45233
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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