What question did this study set out to answer?

To evaluate the efficacy, feasibility, and safety of high-power, short-duration (HPSD) ablation compared with conventional ablation during box isolation for atrial fibrillation.

July 16, 2020Journal of ArrhythmiaOpen Access

High‐power, short‐duration ablation during Box isolation for atrial fibrillation

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Why the study?

Studies evaluating high-power, short-duration ablation during posterior wall Box isolation were limited, despite established safety and efficacy in pulmonary vein isolation.

Does high-power, short-duration ablation improve procedural efficiency and clinical outcomes compared to conventional ablation during Box isolation in patients with atrial fibrillation?

Comparison

HPSD ablation vs conventional technique

Follow-up

12-months

Authors

KKKoichiro KumagaiElectrophysiology HTHideko ToyamaSanno Medical Center

Discussion

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Implication

May shorten BOXI and procedure times in AF ablation; leaves open long-term efficacy and safety versus conventional methods.

Key Points

To evaluate the efficacy, feasibility, and safety of high-power, short-duration (HPSD) ablation compared with conventional ablation during box isolation for atrial fibrillation.
Assessed 160 patients with atrial fibrillation undergoing box isolation allocated to either an HPSD ablation group (n = 80) or a conventional technique group (n = 80).
The HPSD group utilized 50 W with a target lesion size index of 5.0 (50 W for 5 seconds with contact force <10 g near the esophagus), whereas the conventional group used 30–40 W for 30 seconds (20 W near the esophagus).
Box isolation creation time (26 ± 8 vs 47 ± 17 minutes, P < .0001) and total procedure time (65 ± 12 vs 87 ± 23 minutes, P < .0001) were significantly shorter in the HPSD group.
The 12-month single-procedure atrial tachyarrhythmia-free rate was 86.3% in the HPSD group compared with 76.3% in the conventional group (P = .132).
No procedural complications, including gastrointestinal symptoms, occurred in either group.

Structured PICO

Does high-power, short-duration ablation improve procedural efficiency and clinical outcomes compared to conventional ablation during Box isolation in patients with atrial fibrillation?

Population

160 patients with all types of atrial fibrillation

Intervention

Box isolation (BOXI) with high-power, short-duration (HPSD) ablation (50 W, target lesion size index 5.0; near esophagus 50 W for 5 seconds, contact force < 10 g)

Comparator

Box isolation with conventional technique (30-40 W for 30 seconds; 20 W near esophagus)

Outcome

Atrial tachyarrhythmia-free rate at 12-months after a single procedure

High-power, short-duration ablation during Box isolation for atrial fibrillation significantly reduces procedure times without compromising safety or 12-month rhythm outcomes compared to conventional ablation.

Cite This Study

Kumagai et al. (2020) studied this question.

synapsesocial.com/papers/6a70d856660549caf2c57bb2 https://doi.org/10.1002/joa3.12407

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High‐power, short‐duration ablation during Box isolation for atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

High‐power, short‐duration ablation during Box isolation for atrial fibrillation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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