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Article

Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study

by
Paolo Compagnucci
1,2,*,†,
Antonio Dello Russo
1,2,†,
Marco Bergonti
3,4,
Matteo Anselmino
5,
Giulio Zucchelli
6,
Alessio Gasperetti
2,
Laura Cipolletta
1,
Giovanni Volpato
1,2,
Ciro Ascione
3,4,
Federico Ferraris
5,
Yari Valeri
1,2,
Maria Grazia Bongiorni
6,
Andrea Natale
7,
Claudio Tondo
3,4,
Gaetano Maria De Ferrari
5 and
Michela Casella
1,8
1
Cardiology and Arrhythmology Clinic, University Hospital “Ospedali Riuniti”, 60126 Ancona, Italy
2
Department of Biomedical Sciences and Public Health, Marche Polytechnic University, 60126 Ancona, Italy
3
Operation Unit of Arrhythmology, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 20138 Milan, Italy
4
Department of Clinical Sciences and Community Health, University of Milan, 20138 Milan, Italy
5
Division of Cardiology, “Città della Salute e della Scienza di Torino” Hospital, Department of Medical Sciences, University of Turin, 10126 Turin, Italy
6
Second Division of Cardiovascular Diseases, Cardio-Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy
7
Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, Austin, TX 78705, USA
8
Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2022, 11(7), 1802; https://doi.org/10.3390/jcm11071802
Submission received: 13 February 2022 / Revised: 19 March 2022 / Accepted: 21 March 2022 / Published: 24 March 2022
(This article belongs to the Special Issue Recent Advances in Catheter Ablation of Arrhythmias)
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Abstract

A radiofrequency energy lesion transmurality marker incorporating power, contact force, and time (Ablation Index, AI) was shown to be associated with outcomes of catheter ablation (CA) of multiple arrhythmias, but was never systematically assessed in the CA of focal atrial tachycardias (AT). We aimed to evaluate the role of AI as a predictor of outcomes in focal AT CA, and therefore, retrospectively included 45 consecutive patients undergoing CA for focal AT in four referral electrophysiology laboratories. Clinical and procedural information were collected. For each patient, maximum and mean (by averaging maximum AI values for each radiofrequency ablation lesion) AI were measured. The primary outcome was focal AT-free survival, and was systematically assessed with periodical Holter monitors or cardiac implantable electronic devices. CA was acutely effective in each case; however, 20% (n = 9) of the study population experienced a focal AT recurrence over a median follow-up of 288 days. Both maximum and mean AI values were significantly higher among patients without AT recurrences (maximum AI = 568 ± 91, mean AI = 426 ± 105) than in patients with AT relapses (maximum AI = 447 ± 142, mean AI = 352 ± 76, p = 0.036, and p = 0.028, respectively). The optimal cutoffs associated with freedom from recurrences were 461 for maximum AI (sensitivity, 0.89; specificity, 0.56) and 301 for mean AI (sensitivity, 0.97; specificity, 0.44). In a time-to-event analysis, maximum AI was significantly associated with survival free from AT recurrence (p = 0.001), whereas mean AI was not (p = 0.08). In summary, maximum AI is the best procedural parameter associated with the outcomes of CA for focal AT, and may help standardize the procedural approach.
Keywords: focal atrial tachycardia; catheter ablation; electroanatomical mapping; ablation index focal atrial tachycardia; catheter ablation; electroanatomical mapping; ablation index

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MDPI and ACS Style

Compagnucci, P.; Dello Russo, A.; Bergonti, M.; Anselmino, M.; Zucchelli, G.; Gasperetti, A.; Cipolletta, L.; Volpato, G.; Ascione, C.; Ferraris, F.; et al. Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study. J. Clin. Med. 2022, 11, 1802. https://doi.org/10.3390/jcm11071802

AMA Style

Compagnucci P, Dello Russo A, Bergonti M, Anselmino M, Zucchelli G, Gasperetti A, Cipolletta L, Volpato G, Ascione C, Ferraris F, et al. Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study. Journal of Clinical Medicine. 2022; 11(7):1802. https://doi.org/10.3390/jcm11071802

Chicago/Turabian Style

Compagnucci, Paolo, Antonio Dello Russo, Marco Bergonti, Matteo Anselmino, Giulio Zucchelli, Alessio Gasperetti, Laura Cipolletta, Giovanni Volpato, Ciro Ascione, Federico Ferraris, and et al. 2022. "Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study" Journal of Clinical Medicine 11, no. 7: 1802. https://doi.org/10.3390/jcm11071802

APA Style

Compagnucci, P., Dello Russo, A., Bergonti, M., Anselmino, M., Zucchelli, G., Gasperetti, A., Cipolletta, L., Volpato, G., Ascione, C., Ferraris, F., Valeri, Y., Bongiorni, M. G., Natale, A., Tondo, C., De Ferrari, G. M., & Casella, M. (2022). Ablation Index Predicts Successful Ablation of Focal Atrial Tachycardia: Results of a Multicenter Study. Journal of Clinical Medicine, 11(7), 1802. https://doi.org/10.3390/jcm11071802

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