May 13, 2020

Rationale and study design for ablation of paroxysmal atrial fibrillation guided by ablation index: a multi-center, prospective randomized trial (PAF-AI trial)

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Ruhong JiangChen-yang Jiang

Abstract

Pulmonary vein isolation (PVI) has become the cornerstone of atrial fibrillation (AF) ablation, but long-term success rates remains suboptimal, due in large part to late PV reconnection and insufficient ostial substrate modification. To evaluate whether ablation index (AI)-guided PVI with electrical isolation and quantified ostial substrate modification improves clinical outcomes when compared with contact force (CF)-guided ablation in patients with paroxysmal atrial fibrillation (PAF). The PAF-AI trial (ChiCTR1900022041) is a prospective, multi-center, randomized controlled clinical trial enrolling patients with PAF with an indication for catheter ablation. Patients are randomized into a 2:1 fashion to two treatment arms: AI-guided PVI (n = 151) and CF-guided PVI (n = 75). In the AI-guided PVI group, real-time automated display of radiofrequency applications (Visitag™) is used with AI ≥ 500 recommended at the anterior/superior/inferior walls and 350-400 at the posterior wall. In CF-guided PVI group, the value and direction of CF are displayed, with the lesion dots manually annotated. The primary endpoint is the freedom from AF recurrence at 12 months following ablation, without antiarrhythmic drug. The primary pre-specified se...Continue Reading

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Mentioned in this Paper

Platelet Activating Factor
Isolation Aspects
Cardiac Ablation
Controlled Clinical Trials, Randomized
Paroxysmal Atrial Fibrillation
Ablation
Clinical Trials, Randomized
Anti-Arrhythmia Agents
Clinical Trials
Isolate - Microorganism

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