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• W3186272605 abstract "The inability to create transmural and durable lesions is a major contributor to atrial fibrillation ablation failure. Reduction in EGM amplitude post-ablation has been shown to correlate with lesion transmurality but accurate recording of post ablation voltage is hampered by increased noise to signal ratio. This study aimed to determine if post-ablation bipolar voltage (PABV) in the left atrium obtained by the PURE EP™ system (PURE) could be used as a marker of adequate ablation and transmural lesion formation. Ablation data were collected from 11 patients undergoing atrial fibrillation ablation (Age 69±10, 46% Male) using remote navigation (n=9) or manual catheters (n=11). Baseline and post ablation parameters for each ablation point including impedance, bipolar and unipolar voltages, EGM morphology, duration, ablation energy and location were collected. The end point of ablation was 10 seconds after loss of capture (LOC) from the ablating catheter at high output (corresponding to transmural lesion) or a maximum duration of 60 seconds if no loss of capture was observed. A logistic regression model of parameters with significant predictive power for identifying transmural lesion formation was created. The discriminatory performance of the model was tested using the area under a receiver operating characteristic curve (AUC). Of 74 ablation points, 62 demonstrated loss of capture with an average ablation duration of 26±11 sec. Bipolar voltages recorded by PURE were significantly lower at sites with LOC compared to those without LOC (0.48±0.29 vs 0.58±0.21, P=0.04). Univariate screening showed ablation energy and PABV by PURE to be significant determinants of sites with LOC. Multivariable logistic regression incorporating only ablation energy and PABV had good discriminating characteristics with AUC, sensitivity and specificity of 0.73, 0.7 and 0.75, respectively, for predicting lesions with LOC. Accurate unfiltered bipolar left atrial voltage after ablation is significantly lower at sites with transmural lesion. A simple formula that incorporates ablation energy and PABV has good discriminating power to be used as a surrogate marker of ablation end-point." @default.
• W3186272605 created "2021-08-02" @default.
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• W3186272605 date "2021-08-01" @default.
• W3186272605 modified "2023-09-25" @default.
• W3186272605 title "B-PO02-099 POST ABLATION BIPOLAR VOLTAGE BY PURE EP™ AS A MARKER OF TRANSMURAL LESION" @default.
• W3186272605 doi "https://doi.org/10.1016/j.hrthm.2021.06.353" @default.
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