| Title: |
Areas of minimal generator impedance drop during the index atrial fibrillation ablation correlate with pulmonary vein reconnection sites despite adopting the CLOSE protocol |
| Authors: |
Malaweera, A; Boullin, J; Claridge, S; Atha, C; Man, S; Leighton, S; Balasubramaniam, R; Sopher, M; Babu, G |
| Source: |
EP Europace ; volume 24, issue Supplement_1 ; ISSN 1099-5129 1532-2092 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2022 |
| Description: |
Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein (PV) isolation is the cornerstone of atrial fibrillation (AF) management. However, AF recurrence is extremely common after a single procedure. The CLOSE protocol, which is the standardisation of radiofrequency catheter ablation by delivering a point-by-point lesion set defined by ablation index (AI), has demonstrated 80% freedom of AF. Yet PV reconnection is still up to 38% in these patients (1). A small decrease in generator impedance (GI), which is not part of the AI algorithm, has been associated with recovery of PV conduction. Purpose The study aimed to identify whether lesions having a poor impedance drop (PID) after wide area circumferential ablation (WACA) are associated with PV reconnection, despite adopting to the CLOSE protocol. Methods 120 consecutive patients who had both the index (i-AFA) and redo AF ablations (r-AFA) due to AF recurrence at our centre from Jan 2018 to Jun 2021 were screened. 18 patients who had WACA around PVs using high power (40 to 50W) with a minimum AI of 400, whilst adhering the CLOSE protocol during the i-AFA, and who had evidence of PV reconnection during r-AFA, were included in the study. Ones who had left atrial (LA) substrate or cryoablation were excluded. GI was measured between the skin patch and ablation catheter. CARTO® system was used to create LA electroanatomical maps (EAMs) and register ablation lesions. Each WACA around PVs was divided into eight anatomical segments (Figure). PID was defined as an impedance change of |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/europace/euac053.252 |
| Availability: |
https://doi.org/10.1093/europace/euac053.252; https://academic.oup.com/europace/article-pdf/24/Supplement_1/euac053.252/43769875/euac053.252.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.992C4AA5 |
| Database: |
BASE |