Lesion size index-guided cavotricuspid isthmus linear ablation,Journal of Interventional Cardiac Electrophysiology

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Lesion size index-guided cavotricuspid isthmus linear ablation
Journal of Interventional Cardiac Electrophysiology ( IF 2.1 ) Pub Date : 2022-09-08 , DOI: 10.1007/s10840-022-01360-4
Yusuke Murayama ₁ , Jun Kishihara ₁ , Hidehira Fukaya ₁ , Yutaro Mitani ₁ , Daiki Saito ₁ , Gen Matsuura ₁ , Tetsuro Sato ₁ , Hironori Nakamura ₁ , Naruya Ishizue ₁ , Jun Oikawa ₁ , Shinichi Niwano ₁ , Junya Ako ₁

Affiliation

Background

The lesion size index (LSI) predicts radiofrequency (RF) ablation lesion size and is an established parameter for pulmonary vein isolation. However, the effectiveness and safety of LSI for cavotricuspid isthmus (CTI) linear ablation remain unclear.

Methods

This single-center retrospective study included 50 of patients (67 ± 10 years, 68% male) who underwent de novo CTI linear ablation between July 2020 and December 2020. The LSI target was set at 5.0 and 4.0 for the anterior ^2/3 and posterior ^1/3 segments, respectively. Acute procedural parameters of ablation were evaluated.

Results

Acute bidirectional CTI block was achieved in all patients with an RF application time of 4.0 min (3.1–5.0 min), RF application number of 15 ± 7, and length of CTI of 36.9 ± 9.3 mm. First-pass bidirectional conduction block of the CTI was achieved in 39/50 (78%) patients. No major complications were observed. The contact force (CF) per application was significantly lower in the gap tag group than in the non-gap tag group (7 g [7–8 g] vs. 10 g [7–12 g], P = 0.0284).

Conclusions

LSI-guided CTI linear ablation is an effective and safe treatment approach. CF affects gap formation, even when the target LSI is the same.

中文翻译：

病变大小指数引导的三尖瓣峡部线性消融

背景

病变大小指数 (LSI) 预测射频 (RF) 消融病变大小，是肺静脉隔离的既定参数。然而，LSI 对三尖瓣峡部 (CTI) 线性消融的有效性和安全性仍不清楚。

方法

这项单中心回顾性研究包括 50 名患者（67 ± 10 岁，68% 为男性），他们在 2020 年 7 月至 2020 年 12 月期间接受了从头CTI 线性消融术。LSI 目标设定为前 2/3^和4.0后^1/3段，分别。评估了消融的急性程序参数。

结果

所有患者均实现急性双向 CTI 阻滞，射频应用时间为 4.0 分钟（3.1–5.0 分钟），射频应用次数为 15 ± 7 次，CTI 长度为 36.9 ± 9.3 毫米。39/50 (78%) 患者实现了 CTI 的首过双向传导阻滞。没有观察到重大并发症。间隙标签组每次应用的接触力 (CF) 明显低于非间隙标签组（7 g [7–8 g] 对比 10 g [7–12 g]，P = 0.0284 ）。