Optimal lesion size index to prevent conduction gap during pulmonary vein isolation

2018 ◽  
Vol 29 (12) ◽  
pp. 1616-1623 ◽  
Author(s):  
Naomi Kanamori ◽  
Takeshi Kato ◽  
Satoru Sakagami ◽  
Takahiro Saeki ◽  
Chieko Kato ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Lesion Size ◽  
Size Index

scholarly journals Optimized lesion size index (o‐LSI): A novel predictor for sufficient ablation of pulmonary vein isolation

2021 ◽  
Author(s):  
Gen Matsuura ◽  
Jun Kishihara ◽  
Hidehira Fukaya ◽  
Jun Oikawa ◽  
Naruya Ishizue ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Lesion Size ◽  
Size Index

scholarly journals Power, Lesion Size Index and Oesophageal Temperature Alerts During Atrial Fibrillation Ablation

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Milena Leo ◽  
Michala Pedersen ◽  
Kim Rajappan ◽  
Matthew R. Ginks ◽  
Ross J. Hunter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Recurrence Rate ◽  
Posterior Wall ◽  
Lesion Size ◽  
Atrial Fibrillation Recurrence ◽  
Esophageal Temperature ◽  
Size Index

Background: Low radiofrequency powers are commonly used on the posterior wall of the left atrium for atrial fibrillation ablation to prevent esophageal damage. Compared with higher powers, they require longer ablation durations to achieve a target lesion size index (LSI). Esophageal heating during ablation is the result of a time-dependent process of conductive heating produced by nearby radiofrequency delivery. This randomized study was conducted to compare risk of esophageal heating and acute procedure success of different LSI-guided ablation protocols combining higher or lower radiofrequency power and different target LSI values. Methods: Eighty consecutive patients were prospectively enrolled and randomized to one of 4 combinations of radiofrequency power and target LSI for ablation on the left atrium posterior wall (20 W/LSI 4, 20 W/LSI 5, 40 W/LSI 4, and 40 W/LSI 5). The primary end point of the study was the occurrence and number of esophageal temperature alerts per patient during ablation. Acute indicators of procedure success were considered as secondary end points. Long-term follow-up data were also collected for all patients. Results: Esophageal temperature alerts occurred in a similar proportion of patients in all groups. Significantly, shorter radiofrequency durations were required to achieve the target LSI in the 40 W groups. Less than 50% of the radiofrequency lesions reached the target LSI of 5 when using 20 W despite a longer radiofrequency duration. A lower rate of first-pass pulmonary vein isolation and a higher rate of acute pulmonary vein reconnection were recorded in the group 20 W/LSI 5. A lower atrial fibrillation recurrence rate was observed in the 40 W groups compared with the 20 W groups at 29 months follow-up. Conclusions: When guided by LSI, posterior wall ablation with 40 W is associated with a similar rate of esophageal temperature alerts and a lower atrial fibrillation recurrence rate at follow-up if compared with 20 W. These data will provide a basis to plan future randomized trials. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02619396.

scholarly journals What Is the Acute Antral Lesion Size After Pulmonary Vein Isolation Using Different Balloon Ablation Technologies?

2017 ◽  
Vol 81 (2) ◽  
pp. 172-179 ◽  
Author(s):  
Laura Perrotta ◽  
Athanasios Konstantinou ◽  
Stefano Bordignon ◽  
Alexander Fuernkranz ◽  
Daniela Dugo ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Lesion Size ◽  
Balloon Ablation

scholarly journals Is There Any Clinical Significance of the Acute Antral Lesion Size After Pulmonary Vein Isolation Using Different Balloon Technologies or Ablation Energy?

2018 ◽  
Vol 82 (6) ◽  
pp. 1725
Author(s):  
Tolga Aksu ◽  
Tümer Erdem Guler ◽  
Serdar Bozyel ◽  
Kazım Serhan Ozcan ◽  
Kivanc Yalin
Keyword(s):  
Pulmonary Vein ◽  
Clinical Significance ◽  
Pulmonary Vein Isolation ◽  
Lesion Size

scholarly journals Safety and Efficacy of High Power Shorter Duration Ablation Guided by Ablation Index or Lesion Size Index in Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Xing Liu ◽  
Chun Gui ◽  
Weiming Wen ◽  
Yan He ◽  
Weiran Dai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
High Power ◽  
Lesion Size ◽  
Fluoroscopy Time ◽  
Safety And Efficacy ◽  
Ablation Index ◽  
Size Index ◽  
First Pass ◽  
Esophageal Lesion

Background. High power shorter duration (HPSD) ablation may lead to safe and rapid lesion formation. However, the optimal radio frequency power to achieve the desired ablation index (AI) or lesion size index (LSI) is insubstantial. This analysis aimed to appraise the clinical safety and efficacy of HPSD guided by AI or LSI (HPSD-AI or LSI) in patients with atrial fibrillation (AF). Methods. The Medline, PubMed, Embase, Web of Science, and the Cochrane Library databases from inception to November 2020 were searched for studies comparing HPSD-AI or LSI and low power longer duration (LPLD) ablation. Results. Seven trials with 1013 patients were included in the analysis. The analyses verified that HPSD-AI or LSI revealed benefits of first-pass pulmonary vein isolation (PVI) (RR: 1.28; 95% CI: 1.05–1.56, P = 0.01) and acute pulmonary vein reconnection (PVR) (RR: 0.65; 95% CI: 0.48–0.88, P = 0.005) compared with LPLD. HPSD-AI or LSI showed higher freedom from atrial tachyarrhythmia (AT) (RR = 1.32, 95% CI: 1.14–1.53, P = 0.0002) in the subgroup analysis of studies with PVI ± (with or without additional ablation beyond PVI). HPSD-AI or LSI could short procedural time (WMD: −22.81; 95% CI, −35.03 to −10.60, P = 0.0003), ablation time (WMD: −10.80; 95% CI: −13.14 to −8.46, P < .00001), and fluoroscopy time (WMD: −7.71; 95% CI: −13.71 to −1.71, P = 0.01). Major complications and esophageal lesion in HPSD-AI or LSI group were no more than LDLP group (RR: 0.58; 95% CI: 0.20–1.69, P = 0.32) and (RR: 0.84; 95% CI: 0.43–1.61, P = 0.59). Conclusions. HPSD-AI or LSI was efficient for treating AF with shorting procedural, ablation, and fluoroscopy time, higher first-pass PVI, and reducing acute PVR and may increase freedom from AT for patients with additional ablation beyond PVI compared with LPLD. Moreover, complications and esophageal lesion were low and no different between two groups.

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