The Lead Episode 27: A Discussion of Utility and Limitations of Ablation Index for Guiding Therapy in Ventricular Myocardium-Journal of the American College of Cardiology: Clinical Electrophysiology

Journal of the American College of Cardiology: Clinical Electrophysiology

Pdf Summary

A study investigated the utility and limitations of the ablation index (AI) for guiding radiofrequency ablation (RFA) therapy in ventricular myocardium. The researchers performed ex vivo and in vivo experiments using swine hearts to examine the correlation between AI and lesion dimensions in healthy and infarcted ventricles. <br /><br />In ex vivo experiments, there was a good correlation between AI and lesion depth, indicating that AI can accurately predict lesion dimensions in healthy ventricles. However, in in vivo experiments, the correlation was moderate in healthy myocardium and poor in infarcted myocardium. The study also found that different combinations of power, contact force, and baseline impedance resulted in different lesion depths, suggesting that AI alone may not be sufficient to guide ablation.<br /><br />The findings suggest that AI has limited value for guiding ablation in ventricular myocardium, especially in scarred tissue. The small proportional significance of application duration and complex tissue architecture may be factors contributing to the limitations of AI. The study highlights the need for further research and development of AI formulas that are more specific to ventricular tissue.

Keywords

ablation index

radiofrequency ablation

RFA therapy

ventricular myocardium

lesion dimensions

ex vivo experiments

in vivo experiments

healthy ventricles

infarcted ventricles

scarred tissue