4.2 Interventional outcome
In our series, we had a satisfactory acute success rate
(~96%) in achieving complete MI block. Probably, our
systematic approach with the steerable sheath support, the continuous
maintenance of sufficient catheter contact force (>15g) and
the accuracy of the 3D imaging - there were no patient movements due to
general anesthesia - contributed to this high percentage [23].
However, as shown by other studies [24], there will always be a
considerable group of patients in whom we cannot achieve complete MI
block with the available technological means. Thus, in our study, if we
add the percentage of interventional failure (4.2%) and the percentage
of patients presenting with PMF and MI pseudo-block (6.9%) we reach an
11.1%. These patients have a higher likelihood to develop PMF even if
this arrhythmia is not pre-existing, a fact that we need to take into
consideration when we intend to perform the MI line [14-16].
Presumably, reinduction attempts should be performed only to exclude PMF
induction after each successful MI ablation. On the contrary, the
reinduction of AF, despite some relatively contradictory data [25],
does not seem to be a predictor in maintaining SR [26]. In our
study, we also found that MI ablation is a time-consuming procedure with
the mean pure ablation time being almost 11 minutes, something that we
must always take into account for the preparation of the procedural
plan.