Application Study Of Ablation Index In Atrial Fibrillation Ablation

Objective We hypothesized that prospective use of Ablation Index(AI)-guided pulmonary vein isolation(PVI)in paroxysmal atrial fibrillation(AF)patients would result in a low rate of pulmonary vein reconnection and that a high success rate can be achieved with durable sinus rhythm alone when compared to contact force(CF)-guided ablation.Method A total of 100 cases with paroxysmal atrial fibrillation were divided into control group(n=50)and study group(n=50).In all cases,a 3-D navigation system(CARTO 3,Biosense Webster,Inc.)was used to create an electroanatomical map of the left atrium(LA).Pulmonary vein isolation was performed with point-by-point lesions.The ablation points were marked by Visi-Tag mode.The control group did not display AI value,while the study group displayed AI value.The general data,total operation time,pulmonary vein isolation time and X-ray exposure time of the two groups were collected.We observed the postoperative sinus rhythm maintenance rate and complications,and the differences between the two groups were compared.Results1.The average age of the patients in the control group was 61.85 ± 12.84 years old,and the average age of the patients in the study group was 64.28 ± 9.57 years old(P>0.05).The average size of the left atrial diameter of the patients in the control group was 29.75 ± 3.38 mm,while the average size of the left atrial diameter of the patients in the study group was 29.96 ± 4.60 mm(P>0.05).There was no statistical difference between the two groups in age and left atrial diameter.2.All patients successfully achieved complete pulmonary vein isolation during operation.The average operation time was 92.7 ± 23.1 minutes in the control group and 88.3 ± 27.6 minutes in the study group(P>0.05);The average ablation time was58.9 ± 28.4 minutes in the control group and 52.8 ± 23.6 minutes in the study group(P<0.05).3.One patient in the study group developed acute pericardial tamponade(1/50)during operation.The overall incidence of acute pericardial tamponade was 1.0% in all patients with atrial fibrillation who received catheter ablation.No ablation related complications such as cerebral infarction,esophageal atrial fistula,pulmonary vein stenosis and phrenic nerve injury were observed.4.After 12 months of follow-up,44 patients in the control group maintained sinus rhythm(88.0%),6 patients relapsed atrial fibrillation(12.0%),43 patients in the study group maintained sinus rhythm(86.0%),and 7 patients relapsed atrial fibrillation(14.0%).There was no significant difference in the maintenance rate of sinus rhythm between the two groups(P 0.62).Conclusion1.Catheter ablation in patients with paroxysmal atrial fibrillation and guidance with ablation index(AI)may not improve the maintenance rate of postoperative sinus rhythm.2.Applying ablation index(AI)to guide catheter ablation of atrial fibrillation did not increase the incidence of intraoperative and postoperative complications.3.Compared with catheter ablation without ablation index guidance,the application of ablation index does not increase the operation time.4.Applying ablation index(AI)to guide catheter ablation of atrial fibrillation can reduce the time of pulmonary vein single-loop isolation.