AI-guided high-power (50 W) ablation for left atrial anterior and rooflines achieved first-pass conduction block in 75% and 82% of cases, respectively, with no procedural complications.
Observational (n=35)
Does AI-guided high-power (50 W) ablation achieve effective conduction block for anterior and roofline ablation in patients with recurrent AF or AT after PVI?
AI-guided high-power (50 W) ablation is a feasible, fast, and effective technique for achieving conduction block in left atrial anterior and roofline ablation without procedural complications.
OBJECTIVES: To evaluate the feasibility, procedural data, and lesion characteristics of the anterior line (AL) and roofline (RL) ablation by using ablation index (AI)-guided high power (50 W) among patients with recurrent atrial fibrillation (AF) or atrial tachycardia (AT) after pulmonary vein isolation (PVI). METHODS: Data from 35 consecutive patients with macro-reentrant left atrial tachycardia or substrate at the left atrium anterior wall or roof after previous PVI were collected. Ablation power was set to 50 W, targeting AI 500 for AL and 400 for RL. The first-pass conduction block (FPB) was evaluated. The AL was arbitrarily divided into three (caudal, middle, and cranial) segments to analyze the location of conduction gaps in non-FPB patients. RESULTS: A total of 32 AL and 17 RL were deployed and FPB was achieved in 24 (75%) and 14 (82%) of them, respectively. In the non-FPB group, the most frequent gap location along the AL was the middle third. The final block of AL was achieved in 97%, and the block of RL was achieved in 100%. The radiofrequency (RF) ablation time was short (2.9 ± 0.8 min for AL and 46.2 ± 15.6 s for RL). For AL, the female gender was significantly more frequent in FPB than in non-FPB patients (p = .028); patients with non-FPB were associated with significantly longer RF time as compared to patients with FPB (204 ± 47 s vs. 161 ± 41 s; p = .02). No procedural complications occurred. CONCLUSION: AI-guided high-power (50 W) ablation appears to be a feasible, effective, and fast technique for AL and RL ablation.
Zanchi et al. (Fri,) conducted a observational in recurrent atrial fibrillation or atrial tachycardia after pulmonary vein isolation (n=35). Ablation Index-guided high-power short-duration ablation was evaluated on First-pass conduction block (FPB). AI-guided high-power (50 W) ablation for left atrial anterior and rooflines achieved first-pass conduction block in 75% and 82% of cases, respectively, with no procedural complications.