Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
CLOSE protocol with center-specific ablation index target in AF ablation
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Tânia Proença
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:
Tânia Proença; Miguel Martins Carvalho; Ricardo Alves Pinto; Catarina Costa; Carlos Xavier Resende; Pedro Diogo Grilo; João Calvão; Ana Filipa Amador; Gonçalo Pestana; Ana Lebreiro; Luis Adão; Filipe Macedo
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong><span style="font-size:11.0pt">Background</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><span style="font-size:11.0pt">Pulmonary vein (PV) isolation is an established treatment for atrial fibrillation (AF). A contact force (CF)-guided ablation protocol respecting region-specific criteria of lesion contiguity and lesion depth ('CLOSE' protocol) has been associated with high incidence of acute durable PV isolation and a high single-procedure arrhythmia-free survival at 1 year. Differences in ablation index (AI) targets exist between centers, and its optimal value remains unknown. </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong><span style="font-size:11.0pt">Purpose</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><span style="font-size:11.0pt">In the present study, we sought to evaluate the safety and outcomes of our local ablation protocol.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong><span style="font-size:11.0pt">Methods</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><span style="font-size:11.0pt">We retrospectively analyzed 37 patients with paroxysmal AF who underwent antral PV encircling using a CF–sensing catheter in a tertiary center from January 2018 to November 2019. Radiofrequency (RF) was delivered targeting interlesion distance ≤6 mm and ablation index (AI) ≥380 at posterior wall and ≥500 at anterior wall. Cavotricuspid isthmus (CTI) ablation was performed if previous typical atrial flutter was documented. PV isolation was documented with entrance- and exit block and the use of adenosine. Recurrence was defined as any AF, atrial tachycardia (AT), or atrial flutter (AFL) (AF/AT/AFL >30 s) on 24-hour Holter monitoring or 12-lead ECG at 3, 6, and 12 months; or symptoms recurrence.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong><span style="font-size:11.0pt">Results</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><span style="font-size:11.0pt">37 consecutive patients (70% male, median age 53 years-old) underwent antral PV encircling. 30 patients were taking anti</span><span style="font-size:11.0pt">arrhythmic drug (AAD) and 12 were submitted to previous cardioversion (11 with successful cardioversion to sinus rhythm). At the beginning of the procedure only one patient had AF. Procedure and fluoroscopy time were 100 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 19.6 min and 5 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 2.0 min, respectively. Mean AI values, CF and RF time per lesion, were as follows: anterior left PVs - 490 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 21, 9.5 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 1.9 g, 32.0 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 5.1 sec; posterior left PVs – 383 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 11, 10.5 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 3.5 g, 28.8 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 5 sec; anterior right PVs - 498 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 15, 12 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 2,9 g, 32.3 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 4.8 sec; posterior right PVs – 384 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 12, 10.3 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 2.2 g, 27.9 </span><span style="font-size:11.0pt"><span style="font-family:Symbol">±</span></span><span style="font-size:11.0pt"> 3.1 sec. Incidence of first-pass and adenosine-proof isolation were 97% and 95%, respectively. Touch up lesions were applied to ensure isolation, with 100% success at the end of the procedure. CTI ablation was performed in 22% of cases, achieving bidirectional block in all. 76% of patients were discharged on AAD and 24% maintained AAD at one-year follow-up. At 12 months, single-procedure freedom from recurrence was 89%. Only one patient had an acute complication, a femoral haematoma that solved with local compression. </span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><strong><span style="font-size:11.0pt">Conclusions</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Calibri",sans-serif"><span style="font-size:11.0pt">Our initial experience with “CLOSE” protocol with specific AI target supports that an ablation respecting the referred predefined criteria for lesion depth and contiguity results in safe and efficient outcomes with 89% of patients free of arrhythmia during 12-month follow-up. </span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site