Effective Ablation Settings That Predict Chronic Scar After Left Atrial Ablation

Area of Science:

• Electrophysiology
• Cardiac Imaging
• Medical Device Technology

Background:

• Automated annotation aids in identifying scar-forming areas during ablation.
• Effective real-time settings for predicting chronic scar post-ablation remain undetermined.

Purpose of the Study:

• Identify effective real-time parameters for creating chronic scar verified by LGE-CMR.
• Determine optimal ablation settings for durable scar formation.

Main Methods:

• Utilized CARTO3 system with VISITAG Module for pulmonary vein isolation.
• Retrospectively tagged ablation parameters (stability, duration, force, impedance) on EAM.
• Correlated ablation tags with 3-month LGE-CMR scar findings (STAGs vs. NTAGs).

Main Results:

• Ablation time and Force Time Integral (FTI) were significantly higher in scar-associated tags (STAGs).
• No significant differences in contact force, temperature, or impedance between scar and non-scar tags.
• Minimum ablation times and FTI for durable scar were determined at various power settings (25-50W).

Conclusions:

• Minimum ablation time and FTI are critical for durable atrial scar.
• Optimal parameter values for scar creation are dependent on the ablation power setting.