Clinical efficiency and safety of high-power short-duration radiofrequency ablation in treatment of patients with atrial fibrillation

Aim. Evaluation of the clinical efficacy and safety of a high-power short-duration (HPSD) strategy for ablation index (AI) - guided pulmonary vein isolation (PVI) using different power settings. Methods. 185 patients were scheduled for AI guided ablation. Patients were randomized into 2 groups and every group was divided into two subgroups. First group (n=95) PVI was performed with 50W. Second group (n=90) with 45 W. In Ia and IIa AI was 400-450 au (arbitrary unit) in posterior wall and 500-550 au. in the anterior wall. In Ib and IIb AI was 400-450 au in posterior wall and 450-500 au in the anterior wall. Results. Efficacy of the PVI was 100% in all patients. Within 6 months, atrial fibrillation recurred in Ia, Ib, IIa and IIb subgroups were 5/55 (9,0%), 4/40 (10%), 6/50 (12%) и 5/40 (12,5%) p >0,05. First-pass PVI in Ia, Ib, IIa and IIb subgroups were 53/55 (96,36%), 37/40 (92.5%), 46/50 (92%), 36/40 (90,5%) (p>0,05). There was no significant intra operative complications. The total procedure time was 55±10 min, 50±8 min, 60±10 min, 56±9 min (p>0,05). Conclusions. HPSD ablation in patients with atrial fibrillation significantly reduces the procedure time, does not increase the incidence of intraoperative complications and is effective in the short term results.