Impact of tag index and local electrogram for successful first-pass cavotricuspid isthmus ablation

Manabu Kashiwagi, MD; Akio Kuroi, MD; Natsuki Higashimoto, MD; Kazuya Mori, MD; Kazushi Takemoto, PhD; Motoki Taniguchi, MD; Takahiro Nishi, MD; Yoshinori Asae, MD; Shingo Ota, MD; Takashi Tanimoto, MD; Hironori Kitabata, MD; Atsushi Tanaka, MD

Heart Rhythm O2 (Jun 2023)

Impact of tag index and local electrogram for successful first-pass cavotricuspid isthmus ablation

Manabu Kashiwagi, MD,
Akio Kuroi, MD,
Natsuki Higashimoto, MD,
Kazuya Mori, MD,
Kazushi Takemoto, PhD,
Motoki Taniguchi, MD,
Takahiro Nishi, MD,
Yoshinori Asae, MD,
Shingo Ota, MD,
Takashi Tanimoto, MD,
Hironori Kitabata, MD,
Atsushi Tanaka, MD

Affiliations

Manabu Kashiwagi, MD: Address reprint requests and correspondence: Dr Manabu Kashiwagi, Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, Wakayama, 641-8509, Japan.; Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Akio Kuroi, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Natsuki Higashimoto, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Kazuya Mori, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Kazushi Takemoto, PhD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Motoki Taniguchi, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Takahiro Nishi, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Yoshinori Asae, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Shingo Ota, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Takashi Tanimoto, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Hironori Kitabata, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
Atsushi Tanaka, MD: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan

Journal volume & issue: Vol. 4, no. 6
pp. 350 – 358

Abstract

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Background: The optimal ablation index (AI) value for cavotricuspid isthmus (CTI) ablation is unknow. Objective: This study investigated the optimal AI value and whether preassessment of local electrogram voltage of CTI could predict first-pass success of ablation. Methods: Voltage maps of CTI were created before ablation. In the preliminary group, the procedure was performed in 50 patients targeting an AI ≥450 on the anterior side (two-thirds segment of CTI) and AI ≥400 on the posterior side (one-third segment of CTI). The modified group also included 50 patients, but the target AI for the anterior side was modified to ≥500. Results: In the modified group, the first-pass rate of success was higher (88% vs 62%; P 500 on the anterior side was shown to be more effective than an AI >450, and local voltage at a conduction gap was higher than without a conduction gap.

Published in Heart Rhythm O2

ISSN: 2666-5018 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/heart-rhythm-o2

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