Evaluation of an Optimized Workflow for the Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation

Background: A significant number of atrial fibrillation (AF) recurrences occur after initial ablation, often due to pulmonary vein reconnections or triggers from non -pulmonary veins. Material/Methods: Patients with paroxysmal AF who underwent radiofrequency catheter ablation for the first time were enrolled. Base on propensity score matching (1: 1 matching), 118 patients were selected for an optimized workflow for the radiofrequency catheter ablation of paroxysmal AF (OWCA) group and a conventional group. Comparative analysis of the acute and 12 -month clinical outcomes was conducted. Moreover, an artificial intelligence analytics platform was used to evaluate the quality of pulmonary vein isolation (PVI) circles. Results: PVI was successfully achieved in all patients. Incidence of first -pass isolation of bilateral PVI circles was higher ( P =0.009) and acute pulmonary vein reconnections was lower ( P =0.027) in the OWCA group than conventional group. The OWCA group displayed a significant reduction in the number of fractured points ( P <0.001), stacked points ( P =0.003), and a greater proportion of cases in which the radiofrequency index achieved the target value ( P =0.003). Additionally, the contact force consistently met the force over time criteria ( P <0.001) for bilateral PVI circles in the OWCA group, accompanied by a shorter operation time ( P =0.017). During the 12 -month follow-up period, the OWCA group exhibited a higher atrial arrhythmia -free survival rate following the initial ablation procedure than did the conventional group. Conclusions: The optimized workflow for radiofrequency catheter ablation of paroxysmal AF could play a crucial role in creating higher quality PVI circles. This improvement is reflected in a significantly elevated 12 -month atrial arrhythmia -free survival rate.