Lesion index: a novel guide in the path of successful pulmonary vein isolation.

Autor: Dello Russo A; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy. antonio.dellorusso@ccfm.it., Fassini GM; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Casella M; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Romanelli E; Abbott Medical, Sesto San Giovanni, Italy., Pala S; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Riva S; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Catto V; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Moltrasio M; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Tundo F; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Zucchetti M; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Majocchi B; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Dessanai MA; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Pizzamiglio F; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Vettor G; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Ribatti V; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Gasperetti A; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Cellucci S; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Negro G; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Sicuso R; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Carbucicchio C; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy., Tondo C; Heart Rhythm Center, Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138, Milan, MI, Italy.; Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2019 Jun; Vol. 55 (1), pp. 27-34. Date of Electronic Publication: 2018 Dec 04.
DOI: 10.1007/s10840-018-0487-z
Abstrakt: Purpose: Previous studies indicate force time integral (FTI) as a radiofrequency (RF) lesion quality marker, while not considering power supply. Tacticath™ Quartz catheter provides Lesion index (LSI), a lesion quality marker derived by contact force (CF), power supply, and RF time combined. Our aim is to assess LSI and FTI correlation and a LSI-related cutoff of atrial fibrillation (AF) recurrences 12 months after pulmonary vein isolation (PVI).
Methods: We retrospectively enrolled 37 patients who underwent RF ablation using Tacticath™ Quartz catheter. AF recurrence rate was evaluated 3, 6, and 12 months after PVI procedure.
Results: AF recurrence was detected in 32% of patients. FTI mean value was significantly lower in left superior pulmonary vein (LSPV: 256 ± 86 gs vs 329 ± 117 gs, p = 0.05) and right inferior pulmonary vein (RIPV: 253 ± 128 gs vs 394 ± 123 gs p = 0.006) in patients with AF recurrences; no significant differences were found in right superior pulmonary vein (RSPV) and left inferior pulmonary vein (LIPV). LSI instead was significantly higher for all veins in patients without AF recurrences: LSPV (5.2 ± 0.7 vs 4.6 ± 0.8, p = 0.03), LIPV (5.0 ± 0.8 vs 4.5 ± 0.6, p = 0.04), RSPV (5.5 ± 0.6 vs 5.1 ± 0.6, p = 0.05), and RIPV (5.5 ± 0.7 vs 4.7 ± 0.8, p = 0.006). Receiver operator characteristic curve suggests 5.3 as LSI overall cutoff value predicting freedom from disease at 1-year follow-up.
Conclusions: Our preliminary data suggest that a LSI mean value higher than 5.3 can be considered a good predictor of AF freedom at 1-year follow-up.
Databáze: MEDLINE
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