Relationship between Surpoint Tag Index, a Radiofrequency Ablation lesion quality indicator, and Atrial wall thickness in Cavotricuspid isthmus Ablations exhibiting bidirectional block.

Autor: Smith A; Department of Internal Medicine Riverside Methodist Hospital Columbus Ohio USA., Amin AK; Section of Cardiac Electrophysiology Department of Cardiology OhioHealth Heart and Vascular Physicians Riverside Methodist Hospital Columbus Ohio USA., El-Zein R; Department of Internal Medicine OhioHealth Doctors Hospital Columbus Ohio USA., Billakanty SR; Section of Cardiac Electrophysiology Department of Cardiology OhioHealth Heart and Vascular Physicians Riverside Methodist Hospital Columbus Ohio USA., Chopra N; Section of Cardiac Electrophysiology Department of Cardiology OhioHealth Heart and Vascular Physicians Riverside Methodist Hospital Columbus Ohio USA.
Jazyk: angličtina
Zdroj: Journal of arrhythmia [J Arrhythm] 2021 Dec 04; Vol. 38 (1), pp. 118-125. Date of Electronic Publication: 2021 Dec 04 (Print Publication: 2022).
DOI: 10.1002/joa3.12662
Abstrakt: Background: An RFA lesion quality indicator, Surpoint Tag Index ® (TI) incorporates key factors: power, time, and contact force, impacting lesion quality. TI accurately estimates lesion depth in animal studies. However, the relationship between TI and in-vivo atrial wall thickness in patients exhibiting bidirectional block remains unknown.
Objective: To describe the relationship between atrial wall thickness and TI in CTI exhibiting bidirectional block.
Methods: Data from 492 RFA lesions from 25 patients undergoing PVI and CTI ablations in SR with point-by-point RF lesions (<45 W) utilizing a Thermocool Smarttouch ®  SF ablation catheter and CARTO-3 mapping were retrospectively analyzed. Operators were blinded to TI data and CTI thickness. CTI thickness was obtained using ICE images on Cartosound pre-ablation. Durable lesions were defined as part of a lesion set exhibiting bidirectional block of >30 min.
Results: In lesions exhibiting bidirectional block, the thinnest (1-2 mm; 5% lesions) and thickest (8-10 mm; 6% lesions) portions of the CTI correlated with the lowest (429 ± 75) and highest (516 ± 64) TI. The bulk of thickness (2-6 mm; 80%) correlated with a TI of 455 ± 72 ( p  = 0.001). There was a weak but positive correlation between TI and CTI thickness ( r  = 0.2; p  ≤ 0.01). Examined in sectors, the anterior 1/3 rd CTI was the thickest (4.8 ± 1.9 mm) but correlated with a similar TI value (479 ± 75 vs. 471 ± 70; p  = 0.34) as the thinner middle 1/3 rd (3.8 ± 1.7 mm; p  ≤ 0.0001).
Conclusion: A mean TI value of 455 correlates with bidirectional block across the bulk of CTI with lower and higher values needed for the thinner and thicker portions, respectively. Tissue composition, aside from wall thickness, influences TI values for the creation of the bidirectional block.
Competing Interests: None.
(© 2021 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.)
Databáze: MEDLINE
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