AUTHOR=Xiong Qingsong , Liao Jia , Chen Weijie , Xiao Peilin , Du Huaan , He Qushuai , Yin Yuehui , Ling Zhiyu , Chen Shaojie 

TITLE=Tailored Target Ablation Index Guided Pulmonary Vein Isolation in Treating Paroxysmal Atrial Fibrillation: A Single Center Randomized Study in Asian Population (AI-Asian-I)

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.937913

DOI=10.3389/fcvm.2022.937913

ISSN=2297-055X

ABSTRACT=<sec><title>Objective</title><p>To evaluate the efficacy and safety of lower ablation indexes (AI) guided pulmonary vein isolation (PVI) in treating paroxysmal atrial fibrillation (AF).</p></sec><sec><title>Methods</title><p>Ninety patients with paroxysmal AF scheduled for radiofrequency ablation were randomly divided into three groups. The AI targets for PVI were as follows: In group A/B/C, 550/500/450 for roof and anterior wall, and 400/350/300 for posterior/inferior wall. The first-pass PVI rate, ablation time, complications and recurrence of atrial tachyarrhythmia (ATa) were compared.</p></sec><sec><title>Results</title><p>The mean age was 62.5 years (male: 63.0%), mean body mass index (BMI): 24.35 ± 3.66 kg/m<sup>2</sup>. The baseline characteristics were comparable. There was no significant difference in the first-pass PVI rate among the three groups (left-sided-PV: 66.7% vs. 80% vs. 73.3%, <italic>P</italic> = 0.51; right-sided-PV: 70% vs. 83.3% vs. 73.3%, <italic>P</italic> = 0.64), also with similar gap rate during the procedural waiting time. At 1-year follow-up there was no significant difference in the recurrence rate of ATa among the three groups (10% vs. 13.3% vs. 13.3%, <italic>P</italic> = 1.00). The ablation time in the Group C was significantly less than that in the other two groups (47.8 min. vs. 47.0 min. vs. 36.6 min, <italic>P</italic> &lt; 0.001). Higher AI seemed to link a non-significant trend toward higher rate of pericardial effusion (group A + B vs. group C:6.7% vs. 0%, <italic>P</italic> = 0.30), although the rate of overall complications was not different among the three groups.</p></sec><sec><title>Conclusion</title><p>This randomized study shows that, a relatively lower target AI guided ablation may be similarly effective to achieve PVI with significantly reduced ablation time and obtain similar clinical outcome in treating paroxysmal AF in Asian population.</p></sec><sec><title>Clinical Trial Registration</title><p>[<ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>], identifier [NCT:04549714].</p></sec>