The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation
Abstract Purpose We developed the intracardiac echocardiography (ICE) technique to minimize radiation exposure and other recent technology during ablation procedure for atrial fibrillation (AF). The aim of this study was to validate the impact of the current strategy using the recent technology for...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-10-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/joa3.12611 |
| _version_ | 1818576412128313344 |
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| author | Tetsuma Kawaji Takanori Aizawa Shun Hojo Akihiro Kushiyama Hidenori Yaku Kenji Nakatsuma Kazuhisa Kaneda Masashi Kato Takafumi Yokomatsu Shinji Miki |
| author_facet | Tetsuma Kawaji Takanori Aizawa Shun Hojo Akihiro Kushiyama Hidenori Yaku Kenji Nakatsuma Kazuhisa Kaneda Masashi Kato Takafumi Yokomatsu Shinji Miki |
| author_sort | Tetsuma Kawaji |
| collection | DOAJ |
| description | Abstract Purpose We developed the intracardiac echocardiography (ICE) technique to minimize radiation exposure and other recent technology during ablation procedure for atrial fibrillation (AF). The aim of this study was to validate the impact of the current strategy using the recent technology for AF ablation on outcomes after procedure. Methods We evaluated the safety and efficacy of the current strategy in consecutive set of patients undergoing first‐time ablation for AF (N = 233) compared with the conventional strategy in earlier consecutive set of patients (N = 223). The current strategy included the technique of ICE to reduce radiation exposure, Ablation Index®‐guided pulmonary veins isolation, and minimum substrate ablation targeting only for induced AF. Outcome measures were radiation exposure, procedure time, in‐hospital adverse outcomes, and event‐free survival from tachyarrhythmias. Results Puncture‐to‐ablation time was slightly, but significantly increased in the current strategy than in the conventional strategy (48.0 minutes vs 44.7 minutes, P = .002), although total procedure time was significantly decreased in the current strategy (143.9 minutes vs 156.9 minutes, P < .001). Likewise, radiation time and absorbed dose were significantly decreased in the current strategy (9.8 minutes vs 38.8 minutes, P < .001; 102.3 mGy vs 490.5 mGy, P < .001). The incidence of overall in‐hospital adverse outcomes was 3.9% in the current strategy and each complication rate was comparable with the conventional protocol. The event‐free survival from recurrent atrial tachyarrhythmias was not significantly different between two groups (72.3% vs 77.1% at 2‐year, P = .32). Conclusion The current strategy using the recent technology with ICE, lesion index, and minimum substrate ablation was feasible and reduced total procedure time and radiation exposure. However, the arrhythmia‐free survival could not be improved. |
| first_indexed | 2024-12-16T06:13:36Z |
| format | Article |
| id | doaj.art-79b9d749e48a432d8f4f74186315ed21 |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-16T06:13:36Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-79b9d749e48a432d8f4f74186315ed212022-12-21T22:41:19ZengWileyJournal of Arrhythmia1880-42761883-21482021-10-013751278128610.1002/joa3.12611The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillationTetsuma Kawaji0Takanori Aizawa1Shun Hojo2Akihiro Kushiyama3Hidenori Yaku4Kenji Nakatsuma5Kazuhisa Kaneda6Masashi Kato7Takafumi Yokomatsu8Shinji Miki9Department of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiovascular Medicine Graduate School of Medicine Kyoto University Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanDepartment of Cardiology Mitsubishi Kyoto Hospital Kyoto JapanAbstract Purpose We developed the intracardiac echocardiography (ICE) technique to minimize radiation exposure and other recent technology during ablation procedure for atrial fibrillation (AF). The aim of this study was to validate the impact of the current strategy using the recent technology for AF ablation on outcomes after procedure. Methods We evaluated the safety and efficacy of the current strategy in consecutive set of patients undergoing first‐time ablation for AF (N = 233) compared with the conventional strategy in earlier consecutive set of patients (N = 223). The current strategy included the technique of ICE to reduce radiation exposure, Ablation Index®‐guided pulmonary veins isolation, and minimum substrate ablation targeting only for induced AF. Outcome measures were radiation exposure, procedure time, in‐hospital adverse outcomes, and event‐free survival from tachyarrhythmias. Results Puncture‐to‐ablation time was slightly, but significantly increased in the current strategy than in the conventional strategy (48.0 minutes vs 44.7 minutes, P = .002), although total procedure time was significantly decreased in the current strategy (143.9 minutes vs 156.9 minutes, P < .001). Likewise, radiation time and absorbed dose were significantly decreased in the current strategy (9.8 minutes vs 38.8 minutes, P < .001; 102.3 mGy vs 490.5 mGy, P < .001). The incidence of overall in‐hospital adverse outcomes was 3.9% in the current strategy and each complication rate was comparable with the conventional protocol. The event‐free survival from recurrent atrial tachyarrhythmias was not significantly different between two groups (72.3% vs 77.1% at 2‐year, P = .32). Conclusion The current strategy using the recent technology with ICE, lesion index, and minimum substrate ablation was feasible and reduced total procedure time and radiation exposure. However, the arrhythmia‐free survival could not be improved.https://doi.org/10.1002/joa3.12611atrial fibrillationcatheter ablationcontrast agentsintracardiac echocardiographyradiation |
| spellingShingle | Tetsuma Kawaji Takanori Aizawa Shun Hojo Akihiro Kushiyama Hidenori Yaku Kenji Nakatsuma Kazuhisa Kaneda Masashi Kato Takafumi Yokomatsu Shinji Miki The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation Journal of Arrhythmia atrial fibrillation catheter ablation contrast agents intracardiac echocardiography radiation |
| title | The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| title_full | The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| title_fullStr | The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| title_full_unstemmed | The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| title_short | The impact of current strategy using intracardiac echocardiography, lesion index, and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| title_sort | impact of current strategy using intracardiac echocardiography lesion index and minimum substrate ablation on clinical outcomes after catheter ablation procedure for atrial fibrillation |
| topic | atrial fibrillation catheter ablation contrast agents intracardiac echocardiography radiation |
| url | https://doi.org/10.1002/joa3.12611 |
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