Contiguity Between Ablation Lesions and Strict Catheter Stability Settings Assessed by VISITAG^TM Module Improve Clinical Outcomes of Paroxysmal Atrial Fibrillation Ablation　― Results From the VISITALY Study ―

Abstract

drugs (AADs) after ablation. 2-6 A durable PV isolation (PVI) is optimized by continuity in the ablation lesion deployment along the circumferential isolation line. 7, 8 Adequate point-by-point information on lesions could be necessary to guarantee the transmurality, continuity, and durability of ablation. Recently, an automated ablation lesion tagging module has been developed. 9 It incorporates indirect parameters of lesion formation that can be indexed by the user, according to the ablation strategy. Our aim A blation strategies that target the pulmonary veins (PVs) are the cornerstone for most atrial fibrillation (AF) ablation procedures, and electrical isolation with at least evidence of entrance block should be the goal of the procedure. 1 A 12-month success rate, defined as the freedom from AF and/or atrial tachycardia (AT) events, appears to be related to the number of procedures and the optimal contact of the ablation catheter with the tissue, and only moderately to the maintenance of antiarrhythmic Fabrizio Guarracini, MD, PhD; Maria Grazia Bongiorni, MD Background: Our aim was to evaluate the clinical outcome of paroxysmal atrial fibrillation (AF) ablation with contact force technology, using an automated lesion tagging system (VISITAG TM module) with strict criteria of catheter stability.

Electrocardiogram characteristics of P wave associated with successful pulmonary vein isolation in patients with paroxysmal atrial fibrillation: Significance of changes in P‐wave duration and notched P wave

“…Recurrence after ablation is considered the reconnection of electrical conduction between the PV and left atrium (LA) in patients with paroxysmal AF. During a repeat procedure for recurrence cases, there may be multiple PV reconnections, despite the development of advanced ablation techniques and devices (Kim et al, ; Shah et al, ; Zucchelli et al, ). Even reconnection of one PV with a critical arrhythmogenic substrate can be responsible for the recurrence of AF following ablation.…”

The industrialization of ablation: a highly standardized and reproducible workflow for radiofrequency ablation of atrial fibrillation

“…Given that PVI is the cornerstone for all AF ablation, it is possible that AI facilitates stable catheter-tissue contact for consistent and more durable lesion creation around the PVs, thereby improving subsequent long-term outcomes. The associations of catheter stability and lesion contiguity with improved long-term success have been previously demonstrated [19,20]. It will be important to continue observing real-world clinical outcomes as more data become available from standardized AI protocols.…”

2019 APHRS expert consensus statement on three‐dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS

“…The 3D mapping systems with automatic lesion index integration of contact‐force feedback help to visualize and evaluate the efficiency and stability of lesions along the ablation line . Additionally, AF ablation with contact‐force technology and strict criteria of stability was reported as a safe procedure and is associated with an improvement in efficiency and a reduction in AF recurrence …”