Performance of the ablation index during pulmonary vein isolation: periprocedural data from a multicenter registry

Gasimova N.Z. Nechepurenko A.A. Kropotkin E.B. Ivanitsky E.A. Kolunin G.V. Shavshin D.A. Antolic B. Artyukhina E.A. Abdrakhmanov A.S. Korolev K.S. Lebedev D.S. Mikhaylov E.N.
October 2022 Springer

Journal of Interventional Cardiac Electrophysiology
2022 #65 Issue 1 167 - 177 pp.

Purpose: Our study aimed to assess the achievement of target ablation index (AI) values and their impact on first-pass pulmonary vein isolation (FPI) as well as to identify FPI predictors. Methods: Atrial fibrillation (AF) ablation was performed according to the local practice, and target AIs were evaluated. The actual AI was calculated as the median value of all ablation points for the anterior and posterior left atrial (LA) walls. Results: A total of 450 patients from nine centers were enrolled. Patients with first-time ablation (n = 408) were divided into the FPI and non-FPI groups. In the FPI group, a higher median target AI was reported for both the anterior and posterior LA walls than those in the non-FPI group. A higher actual AI was observed for the anterior LA wall in the FPI group. The actual AI was equal to or higher than the target AI for the posterior, anterior, and both LA walls in 54%, 47%, and 35% (n = 158) cases, respectively. Parameters such as hypertension, stroke, ablation power, actual AI value on the anterior wall, target AI values on both LA walls, AI achievement on the posterior wall, carina ablation, and operator experience were all associated with FPI in a univariate logistic regression model; only carina ablation was an independent predictor of FPI. Conclusions: According to our multicenter study, FPI and a target AI were not achieved in a significant proportion of AF ablation procedures. Higher actual and target AI values were associated with FPI, but only carina ablation can independently predict FPI.

Ablation index , Atrial fibrillation , Catheter ablation , Pulmonary vein , Radiofrequency ablation , Registry

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Almazov National Medical Research Centre, 2 Akkuratova str, Saint-Petersburg, 197341, Russian Federation
Federal Center of Cardiovascular Surgery, 4 Pokrovskaya Roscha str, Astrakhan, 414011, Russian Federation
Federal Center of Cardiovascular Surgery, 45 Karaulnaya str, Krasnoyarsk, 660020, Russian Federation
Tyumen Cardiology Research Center, 111 Melnikayte str, Tyumen, 625026, Russian Federation
Federal Center of High Medical Technologies, 4a Kaliningradskoe highway, Kaliningrad, 238312, Russian Federation
University Medical Center, 7 Zaloska cesta, Lyublyana, 1000, Slovenia
Vishnevskiy National Medical Research Center of Surgery, 27 Bolshaya Serpukhovskaya str, Moscow, 117997, Russian Federation
National Research Cardiac Surgery Center, 38 Turan ave, Nur-Sultan, 010000, Kazakhstan
Saint-Petersburg Pediatric University, 2 Litovskaya str, Saint-Petersburg, 194100, Russian Federation

Almazov National Medical Research Centre
Federal Center of Cardiovascular Surgery
Federal Center of Cardiovascular Surgery
Tyumen Cardiology Research Center
Federal Center of High Medical Technologies
University Medical Center
Vishnevskiy National Medical Research Center of Surgery
National Research Cardiac Surgery Center
Saint-Petersburg Pediatric University

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