Atrial fibrillation is a heart rhythm disorder that, due to its increasing prevalence, is becoming an increasingly significant health problem. Catheter radiofrequency ablation is a fundamental minimally invasive treatment method in which the ostia of the pulmonary veins in the left atrium are damaged, thereby interrupting the electrical conduction between the left atrium and the pulmonary veins. During radiofrequency ablation, electroanatomical navigation systems are used to provide the operator with information about the radiofrequency ablation parameter reference values that should be achieved during the procedure. Despite this, cases of unsuccessful radiofrequency ablations still occur, meaning that complete electrical isolation of the pulmonary veins was not achieved during the procedure.
In this study, we analyzed whether the parameters of radiofrequency ablation can provide us with information about the quality of individual ablation lesions. For the study, data on radiofrequency ablation parameters recorded in the electro-navigation system was used. The following parameters were used to evaluate the quality of ablation lesions: catheter position, contact force of the ablation catheter tip on the cardiac tissue, tissue impedance, duration of radiofrequency ablation, force-time integral, and ablation index. The ablation index is calculated using an algorithm that considers the values of several radiofrequency ablation parameters (contact force, power of radiofrequency energy delivery, and duration of radiofrequency ablation).
Ablation points located in areas with preserved electrical conduction along the ablation line were labeled as poor quality ablation points. Ablation points on segments of the ablation line where no electrical conduction was detected and selected in the immediate vicinity of poor quality points, were labeled as good ablation points. We compared the values of selected parameters between good and poor quality ablation points and found statistically significant differences for some of them. The average contact force of the ablation catheter on cardiac tissue was significantly lower at good ablation points, while the duration of radiofrequency ablation was significantly longer.
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