An Ablation Index-guided point-by-point workflow for pulmonary vein isolation resulted in lower mean post-ablation scar burden than a continuous drag approach (6.6% vs 9.6%, P=0.03).
Cohort (n=46)
Does an Ablation Index-guided point-by-point workflow reduce left atrial scar burden and improve lesion continuity compared to a continuous drag workflow in patients undergoing first-time PVI?
An Ablation Index-guided point-by-point workflow for PVI results in lower scar burden, narrower scar width, and more complete encirclement compared to a conventional continuous drag approach.
Absolute Event Rate: 6.6% vs 9.6%
p-value: p=0.03
AIMS: A point-by-point workflow for pulmonary vein isolation (PVI) targeting pre-defined Ablation Index values (a composite of contact force, time, and power) and minimizing interlesion distance may optimize the creation of contiguous ablation lesions whilst minimizing scar formation. We aimed to compare ablation scar formation in patients undergoing PVI using this workflow to patients undergoing a continuous catheter drag workflow. METHODS AND RESULTS: Post-ablation cardiovascular magnetic resonance imaging was performed in patients undergoing 1st-time PVI using a parameter-guided point-by-point workflow (n = 26). Total left atrial scar burden and the width and continuity of the pulmonary vein encirclement were determined on analysis of atrial late gadolinium enhancement sequences. Comparison was made with a cohort of patients (n = 20) undergoing PVI using continuous drag lesions. Mean post-ablation scar burden and scar width were significantly lower in the point-by-point group than in the control group (6.6 ± 6.8% vs. 9.6 ± 5.0%, P = 0.03 and 7.9 ± 3.6 mm vs. 10.7 ± 2.3 mm, P = 0.003). More complete bilateral pulmonary vein encirclements were seen in the point-by-point group (P = 0.038). All patients achieved acute PVI. CONCLUSION: Pulmonary vein isolation using a point-by-point workflow is feasible and results in a lower scar burden and scar width with more complete pulmonary vein encirclements than a conventional drag lesion approach.
O’Neill et al. (Wed,) conducted a cohort in Patients undergoing 1st-time pulmonary vein isolation (n=46). Ablation Index-guided point-by-point workflow vs. Continuous catheter drag workflow was evaluated on Mean post-ablation left atrial scar burden (p=0.03). An Ablation Index-guided point-by-point workflow for pulmonary vein isolation resulted in lower mean post-ablation scar burden than a continuous drag approach (6.6% vs 9.6%, P=0.03).