Lesion size index-guided cavotricuspid isthmus linear ablation
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...
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| Published in | Journal of interventional cardiac electrophysiology Vol. 66; no. 2; pp. 485 - 492 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer US
01.03.2023
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
|---|---|
| AbstractList | BackgroundThe 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.MethodsThis 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.ResultsAcute 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).ConclusionsLSI-guided CTI linear ablation is an effective and safe treatment approach. CF affects gap formation, even when the target LSI is the same. 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.BACKGROUNDThe 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.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.METHODSThis 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.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).RESULTSAcute 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).LSI-guided CTI linear ablation is an effective and safe treatment approach. CF affects gap formation, even when the target LSI is the same.CONCLUSIONSLSI-guided CTI linear ablation is an effective and safe treatment approach. CF affects gap formation, even when the target LSI is the same. 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. 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. 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 and posterior segments, respectively. Acute procedural parameters of ablation were evaluated. 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). LSI-guided CTI linear ablation is an effective and safe treatment approach. CF affects gap formation, even when the target LSI is the same. |
| Author | Oikawa, Jun Kishihara, Jun Fukaya, Hidehira Mitani, Yutaro Matsuura, Gen Ishizue, Naruya Ako, Junya Murayama, Yusuke Saito, Daiki Nakamura, Hironori Sato, Tetsuro Niwano, Shinichi |
| Author_xml | – sequence: 1 givenname: Yusuke surname: Murayama fullname: Murayama, Yusuke organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 2 givenname: Jun orcidid: 0000-0002-5920-4417 surname: Kishihara fullname: Kishihara, Jun email: j_kishihara@med.kitasato-u.ac.jp organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 3 givenname: Hidehira surname: Fukaya fullname: Fukaya, Hidehira organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 4 givenname: Yutaro surname: Mitani fullname: Mitani, Yutaro organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 5 givenname: Daiki surname: Saito fullname: Saito, Daiki organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 6 givenname: Gen surname: Matsuura fullname: Matsuura, Gen organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 7 givenname: Tetsuro surname: Sato fullname: Sato, Tetsuro organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 8 givenname: Hironori surname: Nakamura fullname: Nakamura, Hironori organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 9 givenname: Naruya surname: Ishizue fullname: Ishizue, Naruya organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 10 givenname: Jun surname: Oikawa fullname: Oikawa, Jun organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 11 givenname: Shinichi surname: Niwano fullname: Niwano, Shinichi organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine – sequence: 12 givenname: Junya surname: Ako fullname: Ako, Junya organization: Department of Cardiovascular Medicine, Kitasato University School of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36074285$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s10840-022-01119-x 10.1038/bmt.2012.244 10.1161/CIRCEP.109.871665 10.1007/s10840-022-01182-4 10.1007/s10840-014-9943-6 10.1016/j.jacep.2017.08.016 10.1161/CIRCULATIONAHA.114.014092 10.1007/s10840-022-01197-x 10.1111/jce.14156 10.1111/jce.12707 10.1046/j.1540-8167.2005.40709.x 10.1053/eupc.1999.0048 10.1111/jce.13727 10.4022/jafib.1858 10.1007/s10840-021-01110-y 10.1016/S0735-1097(00)00635-5 10.1093/europace/euw137 |
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| Keywords | Contact force Lesion size index Catheter ablation Cavotricuspid isthmus linear ablation Atrial flutter |
| Language | English |
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The lesion size index (LSI) predicts radiofrequency (RF) ablation lesion size and is an established parameter for pulmonary vein isolation. However,... The lesion size index (LSI) predicts radiofrequency (RF) ablation lesion size and is an established parameter for pulmonary vein isolation. However, the... BackgroundThe lesion size index (LSI) predicts radiofrequency (RF) ablation lesion size and is an established parameter for pulmonary vein isolation. However,... |
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| SubjectTerms | Ablation Atrial Flutter - surgery Cardiology Catheter Ablation - adverse effects Complications Contact force Female Humans Lesions Male Medicine Medicine & Public Health Parameters Radio frequency Retrospective Studies Treatment Outcome Tricuspid Valve - surgery |
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| Title | Lesion size index-guided cavotricuspid isthmus linear ablation |
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