Key result
High-power short-duration PVI plus posterior wall debulking yields ~21% arrhythmia recurrence in unselected AF.
Why the study?
High-power short-duration radiofrequency ablation has improved lesion durability in pulmonary vein isolation, but its long-term clinical outcomes combined with posterior wall debulking as an initial treatment in all-comer AF patients required investigation.
Does high-power short-duration pulmonary vein isolation plus posterior wall debulking prevent arrhythmia recurrence in all-comer atrial fibrillation patients?
Observational (n=142)
No
Does high-power short-duration pulmonary vein isolation plus posterior wall debulking prevent arrhythmia recurrence in all-comer atrial fibrillation patients?
High-power short-duration pulmonary vein isolation combined with posterior wall debulking demonstrates favorable long-term arrhythmia-free survival in a real-world cohort of patients with atrial fibrillation, with no major life-threatening complications.
Answers are grounded in this paper and cite their sources.
May support this ablation strategy in unselected AF; leaves open efficacy versus standard PVI in randomized trials.
BACKGROUND: High-power short-duration radiofrequency ablation has improved lesion durability in pulmonary vein isolation. In this study, we investigate long-term clinical out-comes of high-power short-duration pulmonary vein isolation and posterior wall debulk- ing as an initial treatment modality in all corner atrial fibrillation patients. METHODS: This is a single-center, retrospective, observational study including all patients who have undergone high-power short-duration pulmonary vein and posterior wall deb-ulking, regardless of atrial fibrillation type and/or duration. High-power short-duration power delivery protocol was defined as 45 W at all ablation sites. Clinical and electrocar-diographic follow-up were performed in all patients. RESULTS: One hundred forty-two patients were enrolled in this study. Paroxysmal atrial fibrillation was present in 88 (62%) of patients. The mean follow-up of this study was 36.9 months ± 12.2 months. During the follow-up period, 10 patients (11.4%) with a diag- nosis of paroxysmal atrial fibrillation had recurrence, while recurrence in patients with persistent and long-standing persistent atrial fibrillation was slightly higher (15 patients (28.1%) and 5 patients (50%), respectively). No major life-threatening complicationsoccurred. CONCLUSION: This study has demonstrated excellent arrhythmia-free outcomes in unselected, real world atrial fibrillation patients undergoing high-power short-duration pulmonary vein and debulking posterior wall isolations, however larger randomized trials are warranted.
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Candemır et al. (2022) conducted an observational in Atrial fibrillation (n=142). High-power short-duration pulmonary vein isolation plus posterior wall debulking was evaluated on Arrhythmia recurrence. High-power short-duration pulmonary vein isolation plus posterior wall debulking resulted in an overall arrhythmia recurrence rate of 21.1% over a mean follow-up of 36.9 months in unselected atrial fibrillation patients.
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