Key result
Ablation index-guided high-power ablation achieves 100% successful SVC isolation with no complications.
Why the study?
This study aimed to evaluate the feasibility and safety of superior vena cava isolation using an ablation index-guided high-power ablation strategy in patients with AF after PVI.
Does AI-guided high-power ablation safely achieve superior vena cava isolation in patients with atrial fibrillation after pulmonary vein isolation?
Observational (n=53)
Does AI-guided high-power ablation safely achieve superior vena cava isolation in patients with atrial fibrillation after pulmonary vein isolation?
AI-guided high-power ablation (45 W) appears to be a feasible and safe strategy for achieving superior vena cava isolation in patients with atrial fibrillation.
May support AI-guided high-power SVCI feasibility; hypothesis-generating and requires randomized confirmation before practice change.
Objectives: The ablation index (AI)-guided high-power ablation for pulmonary vein isolation (PVI) apears to be a novel strategy in treating atrial fibrillation (AF). This study aimed to evaluate the feasibility and safety of superior vena cava isolation (SVCI) by using AI-guided high-power ablation strategy among patients with AF after PVI. Methods: Data from 53 patients with AF were collected. Mapping and ablation of SVC was performed after PVI. The ablation power was set to 45 W and the ablation procedure was guided by AI. The SVC was divided into six segments in a cranial view. Applications and locations of radiofrenquency (RF) was recorded. The RF applications and AI value in different SVC walls were compared and analyzed. Results: SVCI was performed in 46 patients and electrical SVCIs were successfully achieved in all patients with a mean of 7.6 ± 2.9 RF applications. The mean time of SVCI procedure was 9.5±4.5 min. RF applications at anteroseptal wall was 38 (10.8%) points in 20 (43.5%) patients, posteroseptal wall was 74 (21.0%) points in 38 (82.6%) patients, posteral wall was 81 (22.9%%) points in 40 (87.0%%) patients, anteroseptal wall was 72 (20.4%) points in 37 (80.4%%) patients, anterolateral wall was 45 (12.7%) points in 27 (58.7%) patients, anteroseptal wall was 43 (12.2%) points in 23 (50.0%) patients. The mean AI value in septal, posterior and anterior walls was higher than that of lateral wall. There was no complication in any cases. Conclusion: AI-guided high-power ablation is feasible and safe strategy in performing SVCI. The RF applications and AI value in different SVC walls varied.
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Cui et al. (2022) conducted an observational in Atrial fibrillation (n=53). Ablation index-guided high-power ablation was evaluated on Successful electrical superior vena cava isolation. Ablation index-guided high-power ablation (45 W) for superior vena cava isolation achieved successful electrical isolation in 100% of patients with no complications.
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