Key result
HPSD ablation in patients >80 is linked to shorter procedures and fewer repeat ablations versus conventional.
Why the study?
Data on atrial fibrillation ablation using high-power short-duration ablation in patients over 80 years were lacking.
Does high-power short-duration radiofrequency ablation improve safety and efficacy compared to conventional ablation in patients over 80 years of age with atrial fibrillation?
Cohort (n=232)
Does high-power short-duration radiofrequency ablation improve safety and efficacy compared to conventional ablation in patients over 80 years of age with atrial fibrillation?
In patients over 80 years old with atrial fibrillation, high-power short-duration ablation is safe and reduces procedure time, x-ray exposure, and repeat ablations compared to conventional ablation.
May support shorter procedures with fewer complications in octogenarian AF ablation; hypothesis-generating and leaves open need for RCTs.
Background: Data on atrial fibrillation (AF) ablation using high-power short-duration (HPSD) ablation in patients over 80 years are lacking. Objective: This study aimed to compare the safety and efficacy of paroxysmal and persistent AF ablation using an HPSD (60-90 W/4-8 sec) vs conventional ablation (30-40 W/30 sec) in a propensity score-matched cohort of patients older than 80 years. Methods: Overall, 232 consecutive patients aged over 80 years undergoing AF ablation were included. Propensity score matching revealed 102 pairs for maximizing comparability. A post-ablation 42-day blanking period was applied. Major complications were defined as those requiring intervention or causing sequels within 30 days following catheter ablation. Conclusions: In very old patients (>80 years), AF ablation using an HPSD approach can be performed safely and effectively with a reduction of procedure duration, x-ray exposure, and fewer repeat ablations compared to a conventional approach. Long-term ablation results are promising with both approaches.
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Martinez et al. (2025) conducted a cohort in Atrial fibrillation (n=232). High-power short-duration (HPSD) ablation vs. Conventional ablation (30-40 W/30 sec) was evaluated on Safety and efficacy (major complications within 30 days) (p=.038). High-power short-duration ablation in patients >80 years safely reduced procedure duration, x-ray exposure, and repeat ablations compared to conventional ablation (p=0.038).
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