Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-168 - Impact Of Technologic Advances Including Contact-force Guided And Ablation Index-guided Ablation On Clinical Outcomes In Patients With Persistent Atrial Fibrillation: A Single Center Experience (ID 237)

  E. Choi: Research (Contracted Grants for PIs and Named Investigators only) - Biosense Webster, Inc..


Background: Technology in radiofrequency ablation has advanced including contact-force (CF) sensing catheter and ablation index (AI) to improve safety and efficacy in atrial fibrillation (AF) ablation.
Objective: We aimed to evaluate how technologic advances influence the ablation outcome of persistent AF (PeAF).
Methods: From 2009 to 2018, we analyzed patients with PeAF who underwent catheter ablation. Patients have categorized 3 groups as follows: AF ablation without CF and AI information (G1), with CF without AI (G2), and with optimal AI-guided ablation (G3). For efficacy assessment, early recurrence (ER) of AF within 3 months after ablation and late recurrence (LR) of AF till 1 year after ablation was evaluated. For safety, cardiac tamponade was evaluated.
Results: A total of 148 patients with PeAF were included (age 58 years, 82% men): 38% were in G1, 29% were in G2, and 33% were in G3. There were no significant differences in baseline characteristics among 3 groups, except for ablation strategy. Additional substrate modification after pulmonary vein isolation (PVI) was performed in 75%, 74%, and 51% (G1, 2, and 3, respectively, p=0.015). G3 had a higher proportion of patients with PVI only ± cavotricuspid isthmus ablation (49%) than G1 and 2 (25% and 26%, respectively). G3 showed the lowest ER and LR compared to G1 and 2 (Figure). Cardiac tamponade was significantly lower in G2 and G3 than G1.
Conclusion: With technologic advances in catheter ablation, lower AF recurrence and complications were observed in patients with PeAF despite less extensive ablation for substrate modification. Safer and more effective ablation could be achieved with optimal AI-guided ablation in patients with PeAF.