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Lepillier A, Strisciuglio T, De Ruvo E, et al. Impact of ablation index settings on pulmonary vein reconnection. J Interv Card Electrophysiol. 2021;doi: 10.1007/s10840-021-00944-w.
Lepillier, A., Strisciuglio, T., De Ruvo, E., Scaglione, M., Anselmino, M., Sebag, F. A., Pecora, D., Gallagher, M. M., Rillo, M., Viola, G., Pisanò, E., Abbey, S., Lamberti, F., Pani, A., Zucchelli, G., Sgarito, G., De Simone, A., Bertaglia, E., Solimene, F., & Stabile, G. (2021). Impact of ablation index settings on pulmonary vein reconnection. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, . https://doi.org/10.1007/s10840-021-00944-w
Lepillier, A, et al. "Impact of ablation index settings on pulmonary vein reconnection." Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing vol. (2021). doi: https://doi.org/10.1007/s10840-021-00944-w
Lepillier A, Strisciuglio T, De Ruvo E, Scaglione M, Anselmino M, Sebag FA, Pecora D, Gallagher MM, Rillo M, Viola G, Pisanò E, Abbey S, Lamberti F, Pani A, Zucchelli G, Sgarito G, De Simone A, Bertaglia E, Solimene F, Stabile G. Impact of ablation index settings on pulmonary vein reconnection. J Interv Card Electrophysiol. 2021 Feb 11; doi: 10.1007/s10840-021-00944-w. Epub 2021 Feb 11. PMID: 33570717.
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J Interv Card Electrophysiol. 2021 Feb 11; doi: 10.1007/s10840-021-00944-w. Epub 2021 Feb 11.

Impact of ablation index settings on pulmonary vein reconnection.

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

A Lepillier, T Strisciuglio, E De Ruvo, M Scaglione, M Anselmino, F A Sebag, D Pecora, M M Gallagher, M Rillo, G Viola, E Pisanò, S Abbey, F Lamberti, A Pani, G Zucchelli, G Sgarito, A De Simone, E Bertaglia, F Solimene, Giuseppe Stabile

Affiliations

  1. Centre Cardiologique du Nord, St Denis, Paris, France.
  2. Clinica Montevergine, Mercogliano, Avellino, Italy.
  3. University of Naples Federico II, Naples, Italy.
  4. Policlinico Casilino, Roma, Italy.
  5. Ospedale Cardinal Massaia, Asti, Italy.
  6. A.O.U. Citta della Salute e della Scienza di Torino, Department of Medical Sciences, University of Turin, Turin, Italy.
  7. Institut Mutualiste Montsouris, Paris, France.
  8. Fondazione Poliambulanza, Brescia, Italy.
  9. St George's Hospital, London, UK.
  10. Casa di Cura Villa Verde, Taranto, Italy.
  11. Ospedale San Francesco, Nuoro, Italy.
  12. Ospedale Vito Fazzi, Lecce, Italy.
  13. Hôpital Privé Du Confluent (HPCN), Nantes, France.
  14. Ospedale Sant'Eugenio, Roma, Italy.
  15. Ospedale di Lecco, Lecco, Italy.
  16. Azienda Ospedaliera Pisana, Pisa, Italy.
  17. A.R.N.A.S. Civico Cristina Benfratelli, Palermo, Italy.
  18. Clinica San Michele, via Montella 16, 81024, Maddaloni, Caserta, Italy.
  19. Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy.
  20. Clinica Montevergine, Mercogliano, Avellino, Italy. [email protected].
  21. Clinica San Michele, via Montella 16, 81024, Maddaloni, Caserta, Italy. [email protected].
  22. Anthea Hospital, Bari, Italy. [email protected].

PMID: 33570717 DOI: 10.1007/s10840-021-00944-w

Abstract

PURPOSE: Ablation index (AI) is a radiofrequency lesion quality marker. The AI value that allows effective and safe pulmonary vein isolation (PVI) is still debated. We evaluated the incidence of acute and late PV reconnection (PVR) with different AI settings and its predictors.

METHODS: The Ablation Index Registry is a multicenter study that included patients with paroxysmal/persistent atrial fibrillation (AF) who underwent first-time ablation. Each operator performed the ablation using his preferred ablation catheter (ThermoCool® SmartTouch or Surround Flow) and AI setting (380 posterior-500 anterior and 330 posterior-450 anterior). We divided the study population into two groups according to the AI setting used: group 1 (330-450) and group 2 (380-500). Incidence of acute PVR was validated within 30 min after PVI, whereas the incidence of late PVR was evaluated at repeat procedure.

RESULTS: Overall, 490 patients were divided into groups 1 (258) and 2 (232). There was no significant difference in the procedural time, fluoroscopy time, and rate of the first-pass PVI between the two study groups. Acute PVR was observed in 5.6% PVs. The rate of acute PVR was slightly higher in group 2 (64/943, 6.8%, PVs) than in group 1 (48/1045, 4.6% PVs, p = 0.04). Thirty patients (6%) underwent a repeat procedure and late PVR was observed in 57/116 (49%) PVs (number of reconnected PV per patient of 1.9 ± 1.6). A similar rate of late PVR was found in the two study groups. No predictors of acute and late PVR were found.

CONCLUSION: Ablation with a lower range of AI is highly effective and is not associated with a higher rate of acute and late PVR. No predictors of PV reconnection were found.

Keywords: Ablation index; Atrial fibrillation; Catheter ablation; Pulmonary vein reconnection

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