Evaluation of an Optimized Workflow for the Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation

Background:A significant number of atrial fibrillation (AF) recurrences occur after initial ablation, often due to pulmonary vein reconnections or triggers from non-pulmonary veins. Material/Methods:Patients with paroxysmal AF who underwent radiofrequency catheter ablation for the first time were enrolled.Base on propensity score matching (1: 1 matching), 118 patients were selected for an optimized workflow for the radiofrequency catheter ablation of paroxysmal AF (OWCA) group and a conventional group.Comparative analysis of the acute and 12-month clinical outcomes was conducted.Moreover, an artificial intelligence analytics platform was used to evaluate the quality of pulmonary vein isolation (PVI) circles. Results:PVI was successfully achieved in all patients.Incidence of first-pass isolation of bilateral PVI circles was higher (P=0.009) and acute pulmonary vein reconnections was lower (P=0.027) in the OWCA group than conventional group.The OWCA group displayed a significant reduction in the number of fractured points (P<0.001),stacked points (P=0.003), and a greater proportion of cases in which the radiofrequency index achieved the target value (P=0.003).Additionally, the contact force consistently met the force over time criteria (P<0.001) for bilateral PVI circles in the OWCA group, accompanied by a shorter operation time (P=0.017).During the 12-month follow-up period, the OWCA group exhibited a higher atrial arrhythmia-free survival rate following the initial ablation procedure than did the conventional group. Conclusions:The optimized workflow for radiofrequency catheter ablation of paroxysmal AF could play a crucial role in creating higher quality PVI circles.This improvement is reflected in a significantly elevated 12-month atrial arrhythmia-free survival rate.