Clinical Study On Isolation Of Pulmonary Vein By High Power Radiofrequency Ablation Of Atrial Fibrillation Guided By Ablation Index

Objective: To observe the safety and long-term efficacy of short-term high-power ablation guided by ablation index(AI)in patients with atrial fibrillation(AF).Methods: Analysis of patients with atrial fibrillation(AF),including paroxysmal AF and persistent AF,who first received high power(40W～50W)short-time ablation to pulmonary vein isolation(PVI)in the Second Hospital of Shanxi Medical University from May 2020 to March 2021.All patients were managed perioperatively according to the routine treatment procedures of our hospital,and individualized ablation was used according to the type of AF.High-power ablation was conducted under the guidance of our general AI experience(anterior wall AI: 450～ 500,posterior wall AI: 350～400,roof and bottom AI: 400～450),and baseline data,first-pass PVI rate,ablation time,operative time,and long-term surgical success rate were analyzed.Results: A total of 73 patients with AF were included in the study.The average age was(61.62±9.64)years.There were 42 males(42/73,56.76%)and 46 paroxysmal AF(46/73,63.01%).All patients achieved PVI.The rate of first-pass PVI in paroxysmal AF was 78.26%,and the ablation time of left atrium,the operation time of the left atrium was(24.02±1.02)min,(43.31±13.84)min,respectively.The rate of first-pass PVI in persistent AF was 81.48%,and the ablation time of the left atrium,the operation time of left atrium was(36.80±2.30)min,(56.33±15.63)min,respectively.There were no serious complications related to ablation and steam pop(POP)during the operation.Only4(4/73,5.48%)patients had a small amount of pericardial effusion(depth≤ 5mm).During the mean follow-up period of(15.54±3.50)months,5(5/73,6.85%)patients were lost to follow-up.The overall success rate was(53/68)77.94%,of which the success rate of paroxysmal AF was(37/43)86.05% and that of persistent AF was(16/25)64%.Conclusion:AI-guided high-power radiofrequency ablation is safe and effective in pulmonary vein isolation in patients with atrial fibrillation.