Efficacy of the optimal ablation index–targeted strategy for pulmonary vein isolation in patients with atrial fibrillation: the OPTIMUM study results

Lee, So‐Ryoung; Choi, Eue Keun; Lee, Eui Jae; Choe, Won Seok; Jin, Myung; Oh, Seil

doi:10.1007/s10840-019-00565-4

Cited by 28 publications

(49 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median RF delivery time, power, CF, and FTI were all significantly lower at the touch up sites (touch up sites vs. control sites; energy delivery time, sec, 20.3 [12.3-21.7] vs. 21.6 [19.8-25.2], p=0.0003; power, W, 23.5 [15][16][17][18][19][20][21][22][23][24] vs. 24 [20][21][22][23][24][25], p<0.0001; CF, g, 7 [6-10.8] vs. 11 [9][10][11][12][13][14][15], p<0.0001; FTI, 126.5[99. 3-208.8] vs. 244[183.5-340.5], p<0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have reported the optimal value of the AI for the PVI and CTI. Although there were minor differences among the studies, the optimal values of the AI for the PVI is 400-500 for the left atrial (LA) anterior wall and 250-400 was for the LA posterior wall (12,13). For the CTI ablation, an AI target of 500 for two-thirds of the anterior segments and 400 for one-third of the posterior segments were needed (14).…”

Section: The Optimal Values Of the Ai In The Svcimentioning

confidence: 99%

See 1 more Smart Citation

The optimal Ablation Index Values for Electrical Isolation of the Superior Vena Cava

Kawano

Mori

Tsutsui

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The ablation index (AI) has been reported to be useful for a durable pulmonary vein isolation (PVI) to treat atrial fibrillation (AF). No study has reported the optimal AI value for the SVC isolation (SVCI). In this study, we aimed to investigate the optimal AI for the SVCI. Methods Thirty-six AF patients who underwent an initial SVCI were enrolled. Ablation was performed at a total of 549 points. The sites where dormant conduction was induced or additional ablation was needed were defined as touch-up sites (n=36). We compared the energy deliver time, power, CF, Force-Time Integral (FTI), and AI between the touch up sites and control sites (n=513). Results The median RF delivery time, power, CF, and FTI were all significantly lower at the touch up sites (touch up sites vs. control sites; energy delivery time,

show abstract

Section: Resultsmentioning

confidence: 99%

Section: The Optimal Values Of the Ai In The Svcimentioning

confidence: 99%

The optimal Ablation Index Values for Electrical Isolation of the Superior Vena Cava

Kawano

Mori

Tsutsui

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Relatively few studies have described the use of lower VS values 28,29 . In the OPTIMUM study, Lee et al evaluated the optimal VS values for avoiding acute PVR and examined the feasibility and efficacy of these targets among a Korean population 30 . Authors found that VS values ≥450 for the anterior/roof segments, ≥350 for the posterior/inferior/carina segments, and an ITD of ≤4 mm decreased acute PVR compared to conventional PVI ablation without the use of VS. Okamatsu et al investigated the role of power on VS‐guided ablation using a target VS of 400 for the anterior, 360 for the posterior, and 260 for the oesophagus 31 .…”

Section: Discussionmentioning

confidence: 99%

Characterizing clinical outcomes and factors associated with conduction gaps in VISITAG SURPOINT‐guided catheter ablation for atrial fibrillation

Inoue

Tanaka

Ikada

et al. 2021

Journal of Arrhythmia

View full text Add to dashboard Cite

Purpose Although usefulness of VISITAG SURPOINT (VS) on pulmonary vein isolation (PVI) in catheter ablation of atrial fibrillation has been reported, optimal VS thresholds can depend on the inter‐tag distance (ITD) and vice versa. We validated the efficacy of PVI with lower target ITDs and VS values than in previous studies. Methods Retrospective review of consecutive patients (N = 100) with paroxysmal (n = 32) or persistent AF (n = 68) undergoing VS‐guided ablation between 09/2018 and 08/2019 was conducted. All procedures were performed by two operators. Target VS values were 425 (anterior), 375 (posterior), and 325 (near the esophagus). Target ITD was 4 mm. Results Acute PVI was achieved in all cases, however, 13 residual gaps in 12 patients were observed after initial encirclement (first pass isolation: 88%). Ten gaps due to spontaneous PV reconnections (PVR) were found in nine patients (9%). These 23 gaps had similar median VS (gap‐related vs non‐gap: 429 vs 410, P = .4545) and power (36 vs 36W, P = .4843), higher contact force (13.8 vs 11.0g, P = .0061), and larger ITD (5.3 vs 3.7mm, P < .001) when compared to the remaining tags. Only ITDs were independently associated with gap formation in multivariate analysis. One‐year Kaplan‐Meier freedom from any atrial arrhythmia was 87.2%. Eight patients received repeat ablation (8.1%) and of these, 6 (75%) were free from PVR. Conclusion Favorable rates of first pass isolation, acute PVR, and long‐term procedure success were achieved using lower VS values than in previous reports. With a target VS value of 375‐425, ITDs of 4 mm was sufficient for durable PVI.

show abstract

“…Optimal AI values based on acute PV reconnection assessment shown in the OPTIMUM study, and established as ≥450 for the anterior/roof segments and ≥350 for the posterior/inferior/carina segments [11]. In the CLOSE protocol, the authors suggest an AI value ≥550 for the anterior LA wall and ≥400 for the posterior wall in order to achieve a durable PVI [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…The AI has been adopted in clinical practice, and its higher values have been shown to be associated with favorable outcomes following AF ablation [9-11]. According to the manufacturer’s recommendations, target AI values are determined by every operator individually during several blinded procedures, and then a median AI is provided for every ablated segment around the PV.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Registry of Atrial Fibrillation Ablation with the Ablation Index Technology: Rationale and Study Design

Gasimova

Колунин²,

Artyukhina

et al. 2020

Cardiology

View full text Add to dashboard Cite

This is a prospective multicenter registry of atrial fibrillation (AF) ablation with the Ablation Index (AI) technology, which has been introduced as a marker predicting ablation lesion depth. The index incorporates the main parameters of radiofrequency point-by-point ablation: power, contact force, and time of ablation. The AI is calculated for every operator depending on personal skills, and there are no strict indications on the range of the parameter considering its safety and efficacy during pulmonary vein isolation. The registry aims to evaluate AI values used in different centers by different operators and to evaluate the optimal limits associated with better acute and long-term AF ablation results.

show abstract

Efficacy of the optimal ablation index–targeted strategy for pulmonary vein isolation in patients with atrial fibrillation: the OPTIMUM study results

Cited by 28 publications

References 27 publications

The optimal Ablation Index Values for Electrical Isolation of the Superior Vena Cava

The optimal Ablation Index Values for Electrical Isolation of the Superior Vena Cava

Characterizing clinical outcomes and factors associated with conduction gaps in VISITAG SURPOINT‐guided catheter ablation for atrial fibrillation

A Prospective Registry of Atrial Fibrillation Ablation with the Ablation Index Technology: Rationale and Study Design

Contact Info

Product

Resources

About