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Comparison of myocardial injury and inflammation between ablation index–guided and conventional contact force–guided ablation in atrial fibrillation patients

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Abstract

Purpose

Ablation index (AI)–guided ablation improves the incidence of arrhythmia recurrence as compared to conventional contact force (CF)–guided ablation. The aim of this study was to elucidate the differences in the biomarkers associated with myocardial injury and inflammation between conventional CF–guided and AI-guided ablation.

Methods

Atrial fibrillation (AF) patients who underwent pulmonary vein isolation (PVI) from the Osaka Rosai Atrial Fibrillation ablation (ORAF) registry were enrolled. We divided the patients into two groups: conventional CF–guided PVI (CF group) and AI-guided PVI (AI group). The differences in biomarkers associated with myocardial injury and inflammation, and long-term durability of PVI between the two groups were evaluated.

Results

This study population included a total of 794 patients (CF-guided, 241 patients; AI-guided, 553 patients). Total application time was significantly shorter, and total application number was significantly smaller in AI than CF group. High-sensitive troponin I (hs-TnI) post-ablation was significantly higher in AI than CF group (p < 0.001), even after taking the total application number and total application time into consideration. No significant differences in inflammatory markers changes from pre- to post-ablation were observed between the two groups. AI-guided ablation was significantly associated with the hs-TnI post-ablation by multiple regression analysis. The PV reconnection ratio was significantly smaller in AI than CF group (p = 0.037).

Conclusions

AI-guided ablation had the ability to create larger lesions than CF-guided ablation despite no increase in inflammation and achieved the better PVI durability than that of CF-guided.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

The authors thank Mr. John Martin for his linguistic assistance with this manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Osaka Rosai Hospital, 3-1179 Nagasonecho, kita-ku, Sakai, Osaka, 591-8025, Japan

    Masamichi Yano, Yasuyuki Egami, Shodai Kawanami, Hiroki Sugae, Kohei Ukita, Akito Kawamura, Hitoshi Nakamura, Koji Yasumoto, Masaki Tsuda, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masami Nishino & Jun Tanouchi

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  1. Masamichi Yano
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  2. Yasuyuki Egami
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  3. Shodai Kawanami
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Correspondence to Masami Nishino.

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Yano, M., Egami, Y., Kawanami, S. et al. Comparison of myocardial injury and inflammation between ablation index–guided and conventional contact force–guided ablation in atrial fibrillation patients. J Interv Card Electrophysiol 66, 2021–2030 (2023). https://doi.org/10.1007/s10840-023-01536-6

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  • DOI: https://doi.org/10.1007/s10840-023-01536-6

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