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Ablation index guided pulmonary vein isolation can reduce early recurrences of atrial tachyarrhythmias
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  • Koji Yasumoto,
  • Yasuyuki Egami,
  • Kohei Ukita,
  • Akito Kawamura,
  • Hitoshi Nakamura,
  • Yutaka Matsuhiro,
  • Masaki Tsuda,
  • Naotaka Okamoto,
  • Akihiro Tanaka,
  • Yasuharu Matsunaga-Lee,
  • Masamichi Yano,
  • Ryu Shutta,
  • Yasushi Sakata,
  • Masami Nishino,
  • Jun Tanouchi
Koji Yasumoto
Osaka Rosai Hospital
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Yasuyuki Egami
Osaka Rosai Hospital
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Kohei Ukita
Osaka Rosai Hospital
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Akito Kawamura
Osaka Rosai Hospital
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Hitoshi Nakamura
Osaka Rosai Hospital
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Yutaka Matsuhiro
Osaka Rosai Hospital
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Masaki Tsuda
Osaka Rosai Hospital
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Naotaka Okamoto
Osaka Rosai Hospital
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Akihiro Tanaka
Osaka Rosai Hospital
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Yasuharu Matsunaga-Lee
Osaka Rosai Hospital
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Masamichi Yano
Osaka Rosai Hospital
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Ryu Shutta
Osaka Rosai Hospital
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Yasushi Sakata
Osaka University Graduate School of Medicine Department of Cardiovascular Medicine
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Masami Nishino
Osaka Rosai Hospital
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Jun Tanouchi
Osaka Rosai Hospital
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Abstract

Introduction: Early recurrence of atrial tachyarrhythmias (ERAT) cause various symptoms and predict worse outcomes after pulmonary vein isolation (PVI). This study aimed to clarify whether ablation index (AI) guided PVI, which is a novel technology of radiofrequency ablation, could reduce ERAT as compared to conventional contact force (CF) guided PVI. Methods: Consecutive AF patients who underwent initial PVI from September 2014 to August 2019 were enrolled. We divided the patients into two groups: patients who underwent AI-guided PVI (AI group) and those who underwent CF-guided PVI (CF group). Using propensity score matching (PSM), we adjusted for the patient backgrounds. We compared the incidence of ERAT and late reconnection rate of isolated PVs during second session between the two groups. ERAT was defined as any atrial tachyarrhythmias ≥30 seconds during a 90-day blanking period. Results: A total of 697 patients (paroxysmal 51%) were enrolled. After the PSM, both groups included 229 patients. The incidence of ERAT was significantly lower in AI group than CF group (21.5% vs. 36.1%, P<0.001). The rate of PV reconnection was lower in AI group than CF group (45.8% vs. 71.4%, P=0.028). Multivariate analysis demonstrated that AI-guided PVI was independently correlated with the incidence of ERAT (OR=0.415, 95%CI=0.269-0.639, P<0.001). Conclusion: AI-guided PVI can reduce ERAT as compared to conventional CF-guided PVI.