Ablation Index-Guided High-Power Radiofrequency Application Shortens the Procedure Time With Similar Outcomes to Conventional Power Application in Atrial Fibrillation Ablation

Abstract

However, the FTI formula does not include RF power, which substantially affect ablation lesion volume. 3 The ablation index (AI) was developed as a similar quantitative ablation lesion marker, that considers CF, RF application time, and RF power in a weighted formula. AI was reported to minimize AF recurrence after ablation. 4-6 Recent studies have shown that high-power RF application can be used for AF ablation with short procedure times. 7-11 However, the use of high-power RF may increase complications related to the application of RF (e.g., steam pops, pericardial effusion, and gastrointestinal complaints). 8 Theoretically, using AI-guided high-power RF can create similar RF lesions in a short time of time without excessive RF application. We previously reported that, in AI-guided PV isolation (PVI), using high-power RF resulted in AF ablation with a shorter procedure time than conventional T he creation of durable lesions is essential to achieve permanent isolation of pulmonary vein (PV) in catheter ablation for atrial fibrillation (AF). In radiofrequency (RF) catheter ablation, several parameters, including RF application time, RF power, catheter contact force (CF), and catheter stability, affect lesion size and lesion durability. The automated ablation lesion tagging module based on catheter stability (VISITAG module; Biosense Webster, Diamond Bar, CA, USA) was developed to visualized RF application points passing the predefined stability criteria on the 3-dimensional (3D) mapping system (CARTO3 System; Biosense Webster). For each VISITAG point, integrated lesion size markers were calculated by CARTO mapping system. The force-time integral (FTI) is an integral parameter of CF and RF application time and has been reported as being useful in AF ablation. 1,2 Background: The impact of high-power radiofrequency (RF) application in ablation index (AI)-guided atrial fibrillation (AF) ablation has not been elucidated.