Ablation Protocols
In the second study, PAF patients were randomly assigned either to a
force-time integral-based (FTI) protocol or a tailored-AI-based (TAI)
protocol.
(1) FTI protocol: Target FTI was set as ≥ 400 gram·second [g·s]
regardless of RF power and WT according to the previous EFFICAS-I based
CF guidelines.5
(2) TAI protocol: WT in each segment for PVI was measured in individuals
before starting ablation; a target AI was individually adjusted
according to the WT in each anatomical segment.
Eighty patients were randomly assigned either to FTI (n=40) or to TAI
(n=40). When a target FTI/AI could not be reached because of catheter
displacement, RF was recommenced at the same point until the target
FTI/AI was achieved. If RF delivery had to be terminated due to a rise
in esophageal temperature or an abrupt impedance drop (>20
ohm), a subtherapeutic FTI/AI lesion was accepted. The upper and the
lower limits of target AI were set to 600 and 300, respectively.
The characteristics of the procedure, including the percentage of
first-pass isolation, the percentage of residual PV potentials and/or
conduction gap, the incidence of the spontaneous PV reconnection and/or
drug-evoked dormant conduction, and the procedure time to complete PVI,
were compared between FTI and TAI.