Two years after pulmonary vein isolation guided by ablation index—a multicenter study
Abstract Background The use of the Ablation Index (AI) software for paroxysmal atrial fibrillation (AF) has been associated with higher acute effectiveness and higher 1‐year arrhythmia freedom. There is, however, a lack of data concerning longer follow‐up. We aim to evaluate the 2‐year outcomes afte...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12696 |
| _version_ | 1818216744841379840 |
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| author | Pedro A. Sousa Luís Puga Luís Adão João Primo Ziad Khoueiry Ana Lebreiro Paulo Fonseca Philippe Lagrange Luís Elvas Lino Gonçalves |
| author_facet | Pedro A. Sousa Luís Puga Luís Adão João Primo Ziad Khoueiry Ana Lebreiro Paulo Fonseca Philippe Lagrange Luís Elvas Lino Gonçalves |
| author_sort | Pedro A. Sousa |
| collection | DOAJ |
| description | Abstract Background The use of the Ablation Index (AI) software for paroxysmal atrial fibrillation (AF) has been associated with higher acute effectiveness and higher 1‐year arrhythmia freedom. There is, however, a lack of data concerning longer follow‐up. We aim to evaluate the 2‐year outcomes after a standardized AI‐guided pulmonary vein isolation (PVI). Methods Prospective, multicenter study of consecutive patients referred for paroxysmal AF ablation from January 2018 to July 2019. PVI was guided by a tailored AI value (≥500 for anterior segment, ≥450 for the roof segments and inferior segments, and 400 for the posterior wall) and an ILD ≤6 mm. The primary endpoints were acute and long‐term effectiveness. Results The study included 218 (842 PV) patients (61% males, median age of 60 [IQR 49–68] years) with paroxysmal AF. First‐pass isolation was obtained in 93% of the patients, with an acute reconnection occurring in 10.6% of the patients (3.2% of the PV) following adenosine trial. After a median follow‐up of 26 (IQR 20–30) months, freedom from any documented atrial arrhythmia was 83.4%, off‐AAD. The rate of adverse events was 1.4%. Although procedural parameters differ across centers (p < 0.001), the acute (p = 0.56) and long‐term effectiveness (p = 0.83) were consistent between centers. Conclusions Patients with paroxysmal AF submitted to an AI‐guided PVI workflow presented high arrhythmia freedom at 2‐years of follow‐up. |
| first_indexed | 2024-12-12T06:56:51Z |
| format | Article |
| id | doaj.art-4d0f9fbbd4be4986aeaaa98006f26e97 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-12T06:56:51Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-4d0f9fbbd4be4986aeaaa98006f26e972022-12-22T00:33:56ZengWileyJournal of Arrhythmia1880-42761883-21482022-06-0138334635210.1002/joa3.12696Two years after pulmonary vein isolation guided by ablation index—a multicenter studyPedro A. Sousa0Luís Puga1Luís Adão2João Primo3Ziad Khoueiry4Ana Lebreiro5Paulo Fonseca6Philippe Lagrange7Luís Elvas8Lino Gonçalves9Pacing & Electrophysiology Unit, Cardiology Department Coimbra's Hospital and University Center Coimbra PortugalPacing & Electrophysiology Unit, Cardiology Department Coimbra's Hospital and University Center Coimbra PortugalCardiology Department University Hospital Center of São João Porto PortugalCardiology Department Vila Nova de Gaia & Espinho Hospital Center PortugalCardiology Department Clinique Saint Pierre Perpignan FranceCardiology Department University Hospital Center of São João Porto PortugalCardiology Department Vila Nova de Gaia & Espinho Hospital Center PortugalCardiology Department Clinique Saint Pierre Perpignan FrancePacing & Electrophysiology Unit, Cardiology Department Coimbra's Hospital and University Center Coimbra PortugalPacing & Electrophysiology Unit, Cardiology Department Coimbra's Hospital and University Center Coimbra PortugalAbstract Background The use of the Ablation Index (AI) software for paroxysmal atrial fibrillation (AF) has been associated with higher acute effectiveness and higher 1‐year arrhythmia freedom. There is, however, a lack of data concerning longer follow‐up. We aim to evaluate the 2‐year outcomes after a standardized AI‐guided pulmonary vein isolation (PVI). Methods Prospective, multicenter study of consecutive patients referred for paroxysmal AF ablation from January 2018 to July 2019. PVI was guided by a tailored AI value (≥500 for anterior segment, ≥450 for the roof segments and inferior segments, and 400 for the posterior wall) and an ILD ≤6 mm. The primary endpoints were acute and long‐term effectiveness. Results The study included 218 (842 PV) patients (61% males, median age of 60 [IQR 49–68] years) with paroxysmal AF. First‐pass isolation was obtained in 93% of the patients, with an acute reconnection occurring in 10.6% of the patients (3.2% of the PV) following adenosine trial. After a median follow‐up of 26 (IQR 20–30) months, freedom from any documented atrial arrhythmia was 83.4%, off‐AAD. The rate of adverse events was 1.4%. Although procedural parameters differ across centers (p < 0.001), the acute (p = 0.56) and long‐term effectiveness (p = 0.83) were consistent between centers. Conclusions Patients with paroxysmal AF submitted to an AI‐guided PVI workflow presented high arrhythmia freedom at 2‐years of follow‐up.https://doi.org/10.1002/joa3.12696ablation indexpulmonary vein isolationstandardized workflowtailored ablationtwo years follow‐up |
| spellingShingle | Pedro A. Sousa Luís Puga Luís Adão João Primo Ziad Khoueiry Ana Lebreiro Paulo Fonseca Philippe Lagrange Luís Elvas Lino Gonçalves Two years after pulmonary vein isolation guided by ablation index—a multicenter study Journal of Arrhythmia ablation index pulmonary vein isolation standardized workflow tailored ablation two years follow‐up |
| title | Two years after pulmonary vein isolation guided by ablation index—a multicenter study |
| title_full | Two years after pulmonary vein isolation guided by ablation index—a multicenter study |
| title_fullStr | Two years after pulmonary vein isolation guided by ablation index—a multicenter study |
| title_full_unstemmed | Two years after pulmonary vein isolation guided by ablation index—a multicenter study |
| title_short | Two years after pulmonary vein isolation guided by ablation index—a multicenter study |
| title_sort | two years after pulmonary vein isolation guided by ablation index a multicenter study |
| topic | ablation index pulmonary vein isolation standardized workflow tailored ablation two years follow‐up |
| url | https://doi.org/10.1002/joa3.12696 |
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