Atrial fibrillation cycle-length (AF-CL) inside the pulmonary veins predicts paroxysmal AF ablation success— the INDUCE-AF study

• Published in: Journal of interventional cardiac electrophysiology 2024-06, Vol.67 (4), p.751-758
• Main Authors: Bergonti, Marco, Ascione, Ciro, Compagnucci, Paolo, Marcon, Lorenzo, Van Leuven, Olivier, Saenen, Johan, Huybrechts, Wim, Miljoen, Hielko, Casella, Michela, Valeri, Yari, Jaïs, Pierre, Sacher, Frederic, Heidbuchel, Hein, Sarkozy, Andrea
• Format: Article
• Language: English
• Subjects: Abbreviations; Ablation; Aged; Atrial Fibrillation - surgery; Cardiac arrhythmia; Cardiology; Catheter Ablation - methods; Female; Fibrillation; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Morphology; Multivariate analysis; Predictive Value of Tests; Prognosis; Prospective Studies; Pulmonary Veins - surgery; Recurrence; Sensitivity and Specificity; Tachycardia; Treatment Outcome; Veins
• ISSN: 1572-8595; 1383-875X; 1572-8595
• DOI: 10.1007/s10840-023-01654-1

Background A novel method to measure atrial fibrillation cycle length (AF-CL) was recently described, based on the average of 10 consecutive signals (FARS10). FARS10 accurately identified pulmonary vein isolation (PVI)-responders among patients with persistent AF. Whether this method is applicable to patients with paroxysmal AF is unknown. Objective The aim of this study is to evaluate the prognostic value of FARS10 measurements in patients with paroxysmal AF. Methods and results We enrolled paroxysmal AF patients undergoing PVI in a prospective multicenter study. After AF induction with a standardized protocol, the AF-CL was measured using FARS-10 method. The primary endpoint was AF/AT-recurrence. One-hundred and four patients were included (61 ± 14 years, 25% females). After a mean follow-up of 12 ± 4 months, AF/AT recurrence rate was 20%. The fastest PV CL (fPV-CL) was independently associated with the primary endpoint at multivariate analysis (HR 1.02, p   160 ms) experience higher AF recurrence rate after PVI and more frequent progression to persistent AF. Graphical abstract In 104 patients with paroxysmal atrial fibrillation (AF) undergoing AF ablation, AF was induced at the beginning of the procedure. Pulmonary vein activity was measured using FARS10 measurement (10 consecutive fastest atrial repetitive similar morphology signals). The value of 160 ms was found to be the best cut-off to discriminate outcomes. At 1-year follow-up, patients with fast veins ( 160 ms). PV activity measured with FARS10 method accurately discriminates pulmonary vein isolation responders, in patients with paroxysmal AF. Abbreviations: AF atrial fibrillation, AT atrial tachycardia, CL cycle length, FARS10: 10 consecutive fastest atrial repetitive similar morphology signal, fPV fastest pulmonary vein, HR hazard ratio,