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In the catheter ablation for AF, we found no significant reduction in the 1-year incidence of recurrent atrial tachyarrhythmias by ATP-guided PVI compared with conventional PVI.

Short-term use of AAD for 90 days following AF ablation reduced the incidence of recurrent atrial tachyarrhythmias during the treatment period, but it did not lead to improved clinical outcomes at the later phase.

Cancer has a non-negligible prevalence in patients with acute coronary syndrome undergoing percutaneous coronary intervention, with a major risk of cardiovascular events and bleedings. Moreover, these patients are often undertreated from clinical despite medical therapy seems to be protective. Registration:The BleeMACS project (NCT02466854).

Limitations of the ablation index background: Ablation index (AI) is a novel marker of lesion quality from radiofrequency (RF) catheter ablation. However, AI reliability has not been fully validated by experimental data. The aim of the present study is to validate AI reliability for estimating lesion size using different settings for RF parameters: contact angle, power delivery, and contact force (CF). Methods and results:We evaluated the lesion size in porcine hearts (N = 108) after RF application at three different contact angles to the myocardium: perpendicular (90°), oblique (45°), and parallel (0°). At each angle, RF power at 25, 30, and 35 W was applied at target CF values of 5, 15, and 30 g as measured by the CF sensor to reach target AIs of 300, 400, 500, and 600. AI value was significantly correlated with lesion depth, width, and volume (R = 0.84, 0.82, and 0.87, respectively, all P < 0.001). Lesion depth decreased with smaller contact angles (45°and 0°). Furthermore, high-power RF energy (35 W) resulted in a significantly smaller lesion volume compared with standard-power energy (30 W). There were no significant differences in lesion size among CF settings.Conclusions: AI was strongly correlated with lesion depth, width, and volume, but only within a small range of contact angles and RF power delivery settings. K E Y W O R D S ablation index, atrial fibrillation, contact force, pulmonary veins isolation, radiofrequency catheter ablation SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Kawaji T, Hojo S, Kushiyama A, et al. Limitations of lesion quality estimated by ablation index: An in vitro study. J Cardiovasc Electrophysiol. 2019;30:926-933.