000168323 001__ 168323
000168323 005__ 20260204153543.0
000168323 0247_ $$2doi$$a10.1093/europace/euad118
000168323 0248_ $$2sideral$$a146847
000168323 037__ $$aART-2023-146847
000168323 041__ $$aeng
000168323 100__ $$aFalasconi, G
000168323 245__ $$aPersonalized pulmonary vein antrum isolation guided by left atrial wall thickness for persistent atrial fibrillation.
000168323 260__ $$c2023
000168323 5060_ $$aAccess copy available to the general public$$fUnrestricted
000168323 5203_ $$aAims
Pulmonary vein (PV) antrum isolation proved to be effective for treating persistent atrial fibrillation (PeAF). We sought to investigate the results of a personalized approach aimed at adapting the ablation index (AI) to the local left atrial wall thickness (LAWT) in a cohort of consecutive patients with PeAF.
Methods and results
Consecutive patients referred for PeAF first ablation were prospectively enrolled. The LAWT three-dimensional maps were obtained from pre-procedure multidetector computed tomography and integrated into the navigation system. Ablation index was titrated according to the local LAWT, and the ablation line was personalized to avoid the thickest regions while encircling the PV antrum. A total of 121 patients (69.4% male, age 64.5 ± 9.5 years) were included. Procedure time was 57 min (IQR 50–67), fluoroscopy time was 43 s (IQR 20–71), and radiofrequency (RF) time was 16.5 min (IQR 14.3–18.4). The median AI tailored to the local LAWT was 387 (IQR 360–410) for the anterior wall and 335 (IQR 300–375) for the posterior wall. First-pass PV antrum isolation was obtained in 103 (85%) of the right PVs and 103 (85%) of the left PVs. Median LAWT values were higher for PVs without first-pass isolation as compared to the whole cohort (P = 0.02 for left PVs and P = 0.03 for right PVs). Recurrence-free survival was 79% at 12 month follow-up.
Conclusion
In this prospective study, LAWT-guided PV antrum isolation for PeAF was effective and efficient, requiring low procedure, fluoroscopy, and RF time. A randomized trial comparing the LAWT-guided ablation with the standard of practice is in progress (ClinicalTrials.gov, NCT05396534).
000168323 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttps://creativecommons.org/licenses/by-nc/4.0/deed.es
000168323 590__ $$a7.9$$b2023
000168323 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b19 / 222 = 0.086$$c2023$$dQ1$$eT1
000168323 592__ $$a2.895$$b2023
000168323 593__ $$aPhysiology (medical)$$c2023$$dQ1
000168323 593__ $$aCardiology and Cardiovascular Medicine$$c2023$$dQ1
000168323 594__ $$a10.3$$b2023
000168323 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000168323 700__ $$aPenela, D
000168323 700__ $$aSoto-Iglesias, D
000168323 700__ $$aFrancia, P
000168323 700__ $$aTeres, C
000168323 700__ $$aSaglietto, A
000168323 700__ $$0(orcid)0000-0001-9187-1773$$aJauregui, B$$uUniversidad de Zaragoza
000168323 700__ $$aViveros, D
000168323 700__ $$aBellido, A
000168323 700__ $$aAlderete, J
000168323 700__ $$aMeca-Santamaria, J
000168323 700__ $$aFranco, P
000168323 700__ $$aGaspardone, C
000168323 700__ $$aSan Antonio, R
000168323 700__ $$aHuguet, M
000168323 700__ $$aCámara, Ó
000168323 700__ $$aOrtiz-Pérez, JT
000168323 700__ $$aMartí-Almor, J
000168323 700__ $$aBerruezo, A
000168323 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000168323 773__ $$g25 (2023), [15 pp.]$$pEuropace$$tEuropace$$x1099-5129
000168323 8564_ $$s1036732$$uhttps://zaguan.unizar.es/record/168323/files/texto_completo.pdf$$yVersión publicada
000168323 8564_ $$s2321932$$uhttps://zaguan.unizar.es/record/168323/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000168323 909CO $$ooai:zaguan.unizar.es:168323$$particulos$$pdriver
000168323 951__ $$a2026-02-04-13:13:45
000168323 980__ $$aARTICLE