January 1, 2018Open Access

Contiguity Between Ablation Lesions and Strict Catheter Stability Settings Assessed by VISITAGTM Module Improve Clinical Outcomes of Paroxysmal Atrial Fibrillation Ablation　― Results From the VISITALY Study ―

GZGiulio ZucchelliElectrophysiology GSGiusy SiricoIstituto Clinico Sant'Ambrogio LRLuca RebellatoElectrophysiology

Structured PICO

Does paroxysmal AF ablation using an automated ablation tracking tool with strict stability criteria improve freedom from atrial tachyarrhythmias compared to manual annotation?

Population

280 adults (aged 18-90 years) with documented symptomatic paroxysmal atrial fibrillation refractory to drug therapy (Class I or III). Mean age 59, 65.2% male (in the study group). Excluded: persistent and permanent AF, previous catheter ablation of AF, NYHA class >II, left atrial diameter >50 mm, unstable angina or acute myocardial infarction within 3 months, prior cardiac surgery within 6 months.

Intervention

Paroxysmal AF ablation (pulmonary vein isolation) using a contact force-sensing catheter and an automated ablation tracking tool (VISITAG module) with strict criteria of catheter stability.

Comparator

Paroxysmal AF ablation using the same contact force-sensing catheter but with manual lesion annotation (without the VISITAG module).

Outcome

Freedom from atrial fibrillation or other atrial tachycardia during the 12 months after ablation, excluding the 3-month blanking period.composite

The use of an automated ablation lesion tagging module with strict stability criteria during paroxysmal AF ablation improves procedural efficiency and 12-month freedom from atrial tachyarrhythmias compared to manual annotation.

Abstract

BACKGROUND: module) with strict criteria of catheter stability. METHODS AND RESULTS: module (42.7±14.5 vs. 50.9±23.6 min; P=0.032; 11.6±7.8 vs. 18.4±12.8 min; P=0.003 and 22.5% vs. 41.2%; P=0.02). Two major complications (1 cardiac tamponade and 1 minor stroke) were observed only in the control group. CONCLUSIONS: Paroxysmal AF ablation with contact force technology and strict criteria of stability using the VISITAG module was a safe procedure, associated with an improvement in efficiency and a reduction of atrial tachyarrhythmia recurrence at the 12-month follow-up compared with manual annotation. Contiguity between lesions seemed to enhance effectiveness outcomes.

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