Department of Cardiology, Japan Self Defense Forces Central Hospital, 1-2-24 Ikejiri, Setagaya, Tokyo, Japan.
Department of Cardiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
J Interv Card Electrophysiol. 2022 Sep;64(3):687-694. doi: 10.1007/s10840-021-01112-w. Epub 2022 Feb 3.
The ablation index (AI), developed as a radiofrequency (RF) catheter ablation composite component endpoint, which incorporates contact force (CF), time, and power in a weighted formula, has been reported to be useful for a durable pulmonary vein isolation (PVI) to treat atrial fibrillation (AF). No study has reported the target AI value for the SVC isolation (SVCI). In this study, we aimed to investigate the target AI for the SVCI.
Thirty-six AF patients who underwent an initial SVCI were enrolled. Ablation was performed at 556 points. The sites where dormant conduction was induced or additional ablation was needed were defined as touch up sites (n = 36). We compared the energy deliver time, power, generator impedance (GI) drop, local bipolar voltage, contact force (CF), force-time integral (FTI), and AI between the touch up sites and the no touch up sites (n = 520).
The FTI and AI were significantly lower at the touch up sites (touch up sites vs. no touch up sites; FTI, 126.5 [99.3-208.8] vs. 244 [184-340.8], p < 0.0001; AI, 350.1 ± 43.6 vs. 277.2 ± 21.8, p < 0.0001). The median value of the AI at the no touch up sites was 350, and no reconnections were seen where the minimum AI value was more than 308. Most of the touch up sites were located in the anterior wall and lateral wall (anterior wall, 20/36 sites [55.6%]; lateral wall, 10/36 sites [27.8%]; septal wall, 6/36 sites [16.7%]; posterior wall, 0/36sites [0.0%]).
The target AI value for the SVCI should be 350, and at least 308 would be needed.
消融指数（AI）是一种射频（RF）导管消融复合终点指标，它将接触力（CF）、时间和功率纳入一个加权公式中，已被报道可用于持久的肺静脉隔离（PVI）以治疗心房颤动（AF）。尚无研究报道 SVC 隔离（SVCI）的目标 AI 值。在本研究中，我们旨在研究 SVCI 的目标 AI 值。
共纳入 36 例接受初次 SVCI 的 AF 患者。消融共进行了 556 个点。将诱导休眠传导或需要额外消融的部位定义为修补部位（n=36）。我们比较了修补部位和非修补部位（n=520）的能量输送时间、功率、发生器阻抗（GI）下降、局部双极电压、接触力（CF）、力-时间积分（FTI）和 AI。
修补部位的 FTI 和 AI 显著低于非修补部位（修补部位与非修补部位相比；FTI，126.5[99.3-208.8]与 244[184-340.8]，p<0.0001；AI，350.1±43.6 与 277.2±21.8，p<0.0001）。非修补部位的 AI 中位数为 350，最小 AI 值大于 308 时未见再连接。大多数修补部位位于前壁和侧壁（前壁，20/36 个部位[55.6%]；侧壁，10/36 个部位[27.8%]；间隔壁，6/36 个部位[16.7%]；后壁，0/36 个部位[0.0%]）。
SVCI 的目标 AI 值应为 350，至少需要 308。
