Influence of power setting on superior vena cava potential during right pulmonary vein isolation

Hijioka, Naoko; Kaneshiro, Takashi; Nehashi, Takeshi; Amami, Kazuaki; Nodera, Minoru; Yamada, Shuichi; Yokokawa, Tetsuro; Misaka, Tomofumi; Takeishi, Yasuchika

doi:10.1007/s10840-021-01058-z

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Radiofrequency power output was set at 45–50 W, contact force was maintained between 10 and 15 g, and inter‐lesion distance was set at 4 mm. The duration of radiofrequency application was determined by ablation index values, which were targeted around 380–450 in the RPV antrum 12,13 …”

Section: Methodsmentioning

confidence: 99%

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Characteristics of right pulmonary vein with an epicardial connection needing additional carina ablation for isolation

Nehashi,

Kaneshiro,

Nodera

et al. 2023

Journal of Arrhythmia

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BackgroundThis study thought to elucidate the anatomical features that can predict an epicardial connection (EC) between the right pulmonary vein (RPV) and right atrium.MethodsWe retrospectively analyzed 251 consecutive patients undergoing initial radiofrequency pulmonary vein isolation. We defined EC as present when RPV could not be isolated with circumferential ablation and additional ablation for the conduction gap if needed, and RPV isolation could be achieved by ablation for the earliest activation site >10 mm inside the initial ablation line. Using computed tomography data, we evaluated the RPV bifurcation angle, and the area occupation ratio of the carina region to the RPV antrum (ARC) for predicting EC. In subjects with EC undergoing RPV activation mapping after circumferential ablation, the correlation between conduction delay and bipolar/unipolar potential voltage in the carina region was investigated.ResultsThere were ECs in 45 out of 251 patients (17.9%). The RPV bifurcation angle (47.7° vs. 38.8°, p < .001) and ARC (37.2% vs. 29.7%, p < .001) were significantly greater in the EC (+) group. Multivariate logistic regression analysis revealed that RPV bifurcation angle (odds ratio [OR]: 1.994, p = .002) and ARC (OR: 3.490, p = .013) were independent predictors of EC. In nine patients with EC undergoing carina region mapping, the unipolar potential voltage was correlated with conduction delay in RPV with EC (R = −0.401, p < .001).ConclusionAnatomical features suggesting a wider RPV carina region could predict the presence of EC, and potential with high voltage could be helpful for detecting EC connection sites.

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Section: Methodsmentioning

confidence: 99%

“…The duration of radiofrequency application was determined by ablation index values, which were targeted around 380–450 in the RPV antrum. 12 , 13 …”

Section: Methodsmentioning

confidence: 99%

Characteristics of right pulmonary vein with an epicardial connection needing additional carina ablation for isolation

Nehashi,

Kaneshiro,

Nodera

et al. 2023

Journal of Arrhythmia

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“…Due to the biophysical properties, HPSD lesions tend to be shallower with a wider diameter [ 71 ]. This characteristic makes HPSD ablation particularly advantageous for SVC ablations, as it minimizes collateral damage—especially near sensitive structures such as the phrenic nerves, without increasing short or long-term complications [ 31 ].…”

Section: Adjunctive Ablation Strategiesmentioning

confidence: 99%

High-Power Short-Duration Ablation of Paroxysmal and Persistent Atrial Fibrillation

Hoyos,

Matos,

Miranda-Arboleda

et al. 2023

Rev. Cardiovasc. Med.

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Catheter ablation has become a cornerstone in atrial fibrillation (AF) therapy, improving freedom from all-atrial arrhythmias, as well as outperforming antiarrhythmic drugs in alleviating AF-related symptoms, reducing hospitalizations, and enhancing quality of life. Nevertheless, the success rate of traditional radiofrequency ablation (RFA) methods remains less than ideal. To address these issues, refinement in RFA strategies has been developed to improve efficacy and laboratory efficiency during pulmonary vein isolation (PVI). High-power short-duration (HPSD) RFA has emerged as a safe strategy to reduce the time required to produce durable lesions. This article reviews critical aspects of HPSD ablation in the management of both paroxysmal and persistent AF, covering aspects such as effectiveness, safety, procedural intricacies, and the underlying biophysics.

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Influence of power setting on superior vena cava potential during right pulmonary vein isolation

Cited by 2 publications

References 26 publications

Characteristics of right pulmonary vein with an epicardial connection needing additional carina ablation for isolation

Characteristics of right pulmonary vein with an epicardial connection needing additional carina ablation for isolation

High-Power Short-Duration Ablation of Paroxysmal and Persistent Atrial Fibrillation

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