ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2019
The modified ablation index: a novel determinant of acute pulmonary vein reconnections after pulmonary vein isolation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 20 citations in OpenAlex.
- Contact Index-Guided Pulsed Field Ablation: A Two-Phase Validation of the Impedance Change Threshold to Prevent Acute Pulmonary Vein Gaps.Journal of arrhythmia · 2026Article
- Wall Thickness-Guided vs. Voltage-Guided Pulmonary Vein Isolation for Atrial Fibrillation.Journal of arrhythmia · 2025Article
- Temporal Changes in Epicardial Adipose Tissue and Left Atrial Substrate After Atrial Fibrillation Ablation: Implications for Procedural Success.Journal of the American Heart Association · 2025Article
- Clinical insights into the role of bepridil in recurrence prevention after ablation of persistent atrial fibrillation.Journal of arrhythmia · 2025Article
- Where is the gap after a 90 W/4 s very-high-power short-duration ablation of atrial fibrillation?: Association with the left atrial-pulmonary vein voltage and wall thickness.Journal of arrhythmia · 2024Article
- Impact of tag index and local electrogram for successful first-pass cavotricuspid isthmus ablation.Heart rhythm O2 · 2023Article
- Trends over the recent 6 years in ablation modalities and strategies, post-ablation medication, and clinical outcomes of atrial fibrillation ablation.Journal of arrhythmia · 2023Article
- Performance of the ablation index during pulmonary vein isolation: periprocedural data from a multicenter registry.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Modified ablation index: a novel determinant of a successful first-pass left atrial posterior wall isolation.Heart and vessels · 2022Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough pulmonary vein isolation (PVI) guided by the ablation index (AI) has been well-developed, acute PV reconnections (PVRs) still occur. This study aimed to compare the prognostic performance of the modified AI and its optimal cut-off value for the prediction of acute PVRs to ensure durable PVI.
methodsThree-dimensional left atrium (LA) voltage maps created before an extensive encircling PVI in 64 patients with atrial fibrillation (AF) (45 men, 62 ± 10 years) were examined for an association between electrogram voltage amplitude recorded from the PV-LA junction and acute post-PVI PVRs (spontaneous PVRs and/or ATP-provoked dormant PV conduction).
resultsAcute PVRs were observed in 22 patients (34%) and 33 (3%) of the 1012 PV segments. Acute PVRs were significantly associated with segments with higher bipolar voltage zones (3.23 ± 1.17 vs. 1.97 ± 1.20 mV, P < 0.0001), lower mean AI values (449 [428-450] vs. 460 [437-486], P = 0.05), and radiofrequency lesion gaps ≥ 6 mm (48 vs. 32%, P = 0.04), but not with contact force, force-time integral, or power. We created the modified AI calculated as AI/LA bipolar voltage, and found it to be significantly lower in areas with acute PVRs than in those without (152 [109-185] vs. 256 [176-413] AU/mV, P < 0.0001). Univariate analysis showed the prognostic performance of the modified AI, with an area under the curve of 0.801 (0.775-0.825), to be the highest of all the significant parameters.
conclusionsLow values of the novel modified AI on the PV-encircling ablation line were strongly associated with acute PVRs.
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