The impact of the procedural parameters on the lesion characteristics associated with AF recurrence: Late‐gadolinium enhancement magnetic resonance imaging (LGE‐MRI) analysis

Autor: Hiroyuki Takahara, Kunihiko Kiuchi, Koji Fukuzawa, Mitsuru Takami, Yu Izawa, Toshihiro Nakamura, Kazutaka Nakasone, Yusuke Sonoda, Kyoko Yamamoto, Yuya Suzuki, Ken‐ichi Tani, Hidehiro Iwai, Yusuke Nakanishi, Mitsuhiko Shoda, Atsushi Murakami, Shogo Yonehara, Noriyuki Negi, Yuichiro Somiya, Ken‐ichi Hirata
Rok vydání: 2023
Předmět:
Zdroj: Journal of Cardiovascular Electrophysiology. 34:527-535
ISSN: 1540-8167
1045-3873
Popis: Lesion gaps assessed by late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) are associated with the atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Animal studies have demonstrated that the catheter-contact force (CF), stability, and orientation are strongly associated with lesion formation. However, the impact of those procedural factors on the lesion characteristics associated with AF recurrence has not been well discussed.A total of 30 patients with paroxysmal AF who underwent catheter ablation were retrospectively enrolled. Radiofrequency (RF) applications were performed with 35W for 30s in a point-by-point fashion under esophageal temperature monitoring. The inter-lesion distance was 4mm. The lesions were visualized by LGE-MRI three months post-procedure and assessed by the LGE volume (ml), gap number (GN), and average gap length (AGL [mm]). The gaps were defined as non-enhancement sites of4 mm. The procedural factors including the catheter-CF, stability, and orientation were calculated on the NavX system.Six (20%) of 30 patients had AF recurrences 12 months post-ablation. A univariate analysis demonstrated that the AGL was associated with AF recurrence (hazard ratio [HR]: 1.20, confidence interval [CI]:1.03 - 1.42, p = 0.02). All AF recurrence were found in patients with an AGL of7 mm. The catheter-CF and stability were associated with an AGL of7mm, but not the orientation (CF: HR: 0.62, CI: 0.39-0.97, p=0.038; stability: HR: 0.8, CI: 0.66-0.98, p=0.027).RF ablation with a low CF and poor catheter stability has a potential risk of creating large lesion gaps associated with AF recurrence. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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