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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 11 - 2024 |
doi: 10.3389/fcvm.2024.1449623
This article is part of the Research Topic Women in General Cardiovascular Medicine View all 6 articles
Ablation Index Value for Transmural Lesions Based on Unipolar Electrograms in Patients with Paroxysmal Atrial Fibrillation Undergoing Pulmonary Vein Isolation
Provisionally accepted
Yijun Sun
1,2
Binhao Wang
1,3
Mingjun Feng
1,3
YU YIBO
1,3
Fang Gao
1,3
Weidong Zhuo
1,3
Yingbo Qi
1,2
Xinhui Qiu
1,2
Huimin Chu
1,3*
Guohua Fu
1,3*- 1 Arrhythmia Center, the First Affiliated Hospital of Ningbo University, Other, Ningbo, China
- 2 Ningbo University, Ningbo, China
- 3 Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Ningbo, China
Background: It remains unclear whether the current recommended ablation index (AI) value is suitable for individualized catheter ablation. Prior research has established that the elimination of the negative component of the unipolar electrogram (UP-EGM) applications reflects the formation of transmural lesion during radiofrequency ablation. The aim of this study was to explore the relationship between AI values when UP-EGM turns positive during pulmonary vein isolation and recommended AI values. Methods: A total of 50 patients with drug-refractory PAF who underwent index RFCA were consecutively included from September 2022 to January 2023. All the patients underwent AI-guided ablation. UP-EGM was also recorded during the procedure. The difference in the AI between the value when the UP-EGM turned completely positive (AIUP-EGM(+)) and the recommended value at the end of ablation (AIEND) was compared.Results: A total of 2 954 lesion points were detected in 50 patients. The average values of AIUP-EGM(+) at the anterior wall and the posterior wall were 420.9 and 267.4, respectively. The average AIEND values were 524.3 and 393.9 at the anterior wall and the posterior wall, respectively. The percentage of increase in the AI between the AIUP-EGM(+) and AIEND groups was 22%, 28% at the anterior wall and 47%,49% at the posterior wall (P<0.001). After a mean follow-up duration of 11.30 ± 2.10 months, 44 patients (88%) remained in sinus rhythm without antiarrhythmic drugs.The AIUP-EGM(+) was lower than the recommended value for all the pulmonary vein regions. The recommended AI value seems to be too high for the posterior and inferior walls, but this remains to be proven in future research.
Keywords: Unipolar electrogram, Ablation index, Paroxysmal atrial fibrillation, Pulmonary vein isolation, cather ablation
Received: 15 Jun 2024; Accepted: 11 Nov 2024.
Copyright: © 2024 Sun, Wang, Feng, YIBO, Gao, Zhuo, Qi, Qiu, Chu and Fu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Huimin Chu, Arrhythmia Center, the First Affiliated Hospital of Ningbo University, Other, Ningbo, China
Guohua Fu, Arrhythmia Center, the First Affiliated Hospital of Ningbo University, Other, Ningbo, China
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