Key result
High-power short-duration ablation was superior to low-power long-duration ablation in maintaining sinus rhythm at 12 months (87.32% vs 67.12%, P=0.0039).
Why the study?
Different results have been described after atrial fibrillation ablation, motivating an evaluation of whether first-time ablation with high-power short-duration yields better outcomes than low-power long-duration.
Does high-power short-duration ablation improve sinus rhythm maintenance compared to low-power long-duration ablation in patients undergoing first-time atrial fibrillation ablation?
Observational (n=144)
Does high-power short-duration ablation improve sinus rhythm maintenance compared to low-power long-duration ablation in patients undergoing first-time atrial fibrillation ablation?
Absolute Event Rate: 87.32% vs 67.12%
p-value: p=0.0039
High-power short-duration ablation for atrial fibrillation is associated with a significantly higher rate of sinus rhythm maintenance at 12 months and shorter procedure times compared to low-power long-duration ablation.
HPSD may reduce AF recurrence; hypothesis-generating and requires randomized confirmation before practice change.
Introduction: Different results are described after atrial fibrillation ablation and multiples predictors of recurrence are well established. Objective: Evaluate and analyze if patients submitted to first time atrial fibrillation (AF) ablation with high-power short-duration (HPSD) have better outcomes compared to low-power long-duration (LPLD). Methods: Observational, retrospective study, 144 patients submitted to HPSD and LPLD ablation. HPSD: 71 patients, 50(70.42%) males, mean age 59.73 years, 52(73.24%) hypertension, 44(61.97%) obstructive apnea, 23(32.39%) arterial disease, 20(28.17%) Diabetes, and 10(14.08%) strokes. CHADS2VASC2 2.57. CT: 73 patients, 50(68.49%) males, mean age 60.7 years, 53(72.60%) hypertension, 41(56.16%) obstructive apnea, 28(38.36%) arterial disease, 14(19.17%) Diabetes and 8 (10.96%) strokes. CHAD2SVASC2 2.22. Results: Recurrence occurred in 33 patients (22.92%) at 12 months follow-up, of these, HPSD with 9 patients and LPLD with 24 patients. At the end of study 62 (87.32%) of 71 HPSD patients were in sinus rhythm comparing to 49 (67.12%) of 73 patients in LPLD (P of .0039). Conclusion: HPSD compared to LPLD showed a superiority in maintaining sinus rhythm at 12 months and a significant lower recurrence rate. Also, lower procedure time, esophageal heating and radiofrequency time was significant lower in HPSD technique.
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Fabrício Vassallo (2020) conducted an observational in Atrial fibrillation (n=144). High-power short-duration (HPSD) ablation vs. Low-power long-duration (LPLD) ablation was evaluated on Maintaining sinus rhythm at 12 months (p=0.0039). High-power short-duration ablation was superior to low-power long-duration ablation in maintaining sinus rhythm at 12 months (87.32% vs 67.12%, P=0.0039).
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