Key result
High-power 45W CLOSE-guided PVI cuts procedure time ~22 minutes versus 35W with similar AF recurrence.
Why the study?
CLOSE-guided AF ablation is based on contiguous, optimized point-by-point lesions, but the optimal radiofrequency power remains unknown.
Does high power (45 W) radiofrequency ablation improve procedural efficiency and safety compared to standard power (35 W) in patients with paroxysmal AF undergoing CLOSE-guided pulmonary vein isolation?
RCT (n=96)
1:1
No
Does high power (45 W) radiofrequency ablation improve procedural efficiency and safety compared to standard power (35 W) in patients with paroxysmal AF undergoing CLOSE-guided pulmonary vein isolation?
Absolute Event Rate: 80% vs 102%
p-value: p=<0.001
High power (45 W) CLOSE-guided ablation significantly improves procedural efficiency with similar midterm efficacy compared to standard power, but warrants caution at the posterior wall due to a narrower safety margin regarding esophageal injury.
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High-power CLOSE-guided PVI shortens procedure time with similar 6-month efficacy; supports efficiency gains but cautions posterior wall use for esophageal safety.
Wielandts et al. (2020) conducted an RCT in Paroxysmal atrial fibrillation (n=96). CLOSE-guided pulmonary vein isolation using high power vs. Standard CLOSE protocol (35 W) was evaluated on Procedure time (minutes) (p=<0.001). High power (45 W) CLOSE-guided pulmonary vein isolation significantly reduced procedure time compared to standard 35 W (80 vs 102 minutes, P<0.001) with similar 6-month AF recurrence.