Very high-power short-duration catheter ablation was as safe as conventional ablation and improved 12-month freedom from atrial arrhythmia in persistent AF (44.1% vs. 34.2%; P=0.010).
Cohort (n=1,115)
No
Does very high-power short-duration catheter ablation improve efficacy and safety compared to conventional ablation in patients with atrial fibrillation?
Very high-power short-duration ablation is as safe as conventional ablation and improves long-term efficacy in patients with persistent atrial fibrillation, while significantly reducing procedure times.
Absolute Event Rate: 44.1% vs 34.2%
p-value: p=0.010
AIMS: This retrospective study sought to compare complication rates and efficacy of power-controlled very high-power short-duration (vHPSD) and conventional catheter ablation in a large cohort of patients with atrial fibrillation (AF). METHODS AND RESULTS: We analyzed 1115 consecutive patients with AF (38.7% paroxysmal, 61.3% persistent) who received first-time catheter ablation at our centre from 2015 to 2021. Circumferential pulmonary vein isolation ± additional substrate ablation using an irrigated-tip catheter was performed with vHPSD (70 W/5-7 s or 60 W/7-10 s) in 574 patients and with conventional power (30-35 W/15-30 s) in 541 patients. Baseline characteristics were well-balanced between groups (mean age 65.1 ± 11.2 years, 63.4% male). The 30-day incidence of cardiac tamponade 2/574 (0.35%) vs. 1/541 (0.18%), P = 0.598, pericardial effusion ≥ 10 mm 2/574 (0.35%) vs. 1/541 (0.18%), P = 0.598 and transient ischaemic attack 1/574 (0.17%) vs. 2/541 (0.37%), P = 0.529 was not significantly different between vHPSD and conventional ablation. No stroke, atrio-esophageal fistula, cardiac arrest or death occurred. Procedure (122.2 ± 46.8 min vs. 155.0 ± 50.5 min, P < 0.001), radiofrequency (22.4 ± 19.3 min vs. 52.9 ± 22.0 min, P < 0.001), and fluoroscopy (8.1 ± 7.2 vs. 9.2 ± 7.4, P = 0.016) duration were significantly shorter in the vHPSD group. At 12 months follow-up, freedom of any atrial arrhythmia was 44.1% vs. 34.2% (P = 0.010) in persistent AF and 78.1% vs. 70.2% in paroxysmal AF (P = 0.068). CONCLUSION: vHPSD ablation is as safe as conventional ablation and is associated with an improved long-term efficacy in persistent AF.
Popa et al. (Mon,) conducted a cohort in Atrial fibrillation (n=1,115). Very high-power short-duration (vHPSD) catheter ablation vs. Conventional catheter ablation (30-35 W) was evaluated on Freedom of any atrial arrhythmia at 12 months in persistent AF (p=0.010). Very high-power short-duration catheter ablation was as safe as conventional ablation and improved 12-month freedom from atrial arrhythmia in persistent AF (44.1% vs. 34.2%; P=0.010).