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A question of time: ablation index may spare the waiting period after pulmonary vein isolation
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Diana De Campos
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Diana Decampos; Pedro Sousa; Luís Elvas; Ziad Lhoueiry; Philippe Lagrange; João Primo; Paulo Fonseca; Luis Adão; Ana Lebreiro; Lino Gonçalves
Abstract
<p>Background: Spontaneous pulmonary vein (PV) reconnection is a time-dependent process. A waiting phase of 20-30 min is a guideline recommendation. Nevertheless, data supporting this recommendation mostly arise from studies without contact force-sensing ablation catheters. A new software called “Ablation Index” (AI) has been developed for utilization during PVI, potentially allowing a higher acute success.</p> <p>Objective: To assess if the new software AI can spare the required waiting period after PVI.</p> <p>Methods: This multicentre, prospective, randomized study consecutively recruited patients referred for first-time catheter ablation of symptomatic drug-refractory paroxysmal AF. Patients were enrolled in 1:1 ratio to PVI with AI and 20 min of waiting time versus PVI with AI without a waiting period. Primary endpoints focused on the acute and 1 year AF recurrence outcome.</p> <p>Results: A total of 128 patients were included. Four patients were lost to follow-up. A total of 124 patients were included: 61 in the waiting period group and 63 in the no waiting period group. Mean age was 57.8±13.5 years and 57.3% were male. Mean left ventricular ejection fraction was 60.6±6.7%. The was no significant difference between groups regarding baseline characteristic, echocardiographic and procedure data. Acute PV recurrence occurred in 3 (2.4%) patients; 2 (3.3%) in the waiting period time group and 1 (1.6%) in the group without waiting period (P=0.613). Adenosine testing after right- and left-sided PVI revealed dormant conduction in 4 patients (3.2%). During a mean follow-up time of 14.9±5.5 months, 12.9% patients had recurrence of AF; 9.8% in the waiting period group and 15.9% in the no waiting period group. AF recurrence was similar between patients with and without waiting period (P=0.489 of Log Rank test for equality of hazard function).</p> <p>Conclusion: Paroxysmal AF patients submitted to PVI with the Ablation Index software do not require a waiting period time.</p>
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