High-power, short-duration (50 W) ablation for superior vena cava isolation significantly reduced procedure time (10.8 vs 14.8 min; p<0.01) and radiofrequency duration compared to conventional ablation.
Cohort (n=100)
Does high-power, short-duration ablation improve procedural efficiency and safety compared to conventional ablation in patients undergoing superior vena cava isolation?
A 50-W high-power, short-duration ablation strategy for superior vena cava isolation is safe and significantly reduces procedure time and radiofrequency duration compared to conventional ablation.
Absolute Event Rate: 10.8% vs 14.8%
p-value: p=<.01
INTRODUCTION: The optimal ablation strategy is unknown regarding a superior vena cava isolation (SVCI). This study aimed to examine the feasibility and safety and to analyze the lesion characteristics of the SVCI using high-power, short-duration (HPSD) ablation. METHODS AND RESULTS: A total of 100 patients underwent an index SVCI using HPSD (n = 50, HPSD group) or conventional lower-power and longer-duration (n = 50, LPLD group) ablation, using the Thermocool Smarttouch SF. In the HPSD group, ablation was performed with a power of 50 W for 7 s, and was limited to 4 s at the lateral segment close to the right phrenic nerve. The ablation setting used in the LPLD group was 20-25 W for 20-30 s and was limited to 10-20 W for 15-30 s at the lateral segment when diaphragmatic capture was seen. An electrical SVCI was achieved in all patients. The HPSD group required a significantly shorter procedure time (10.8 ± 3.2 vs. 14.8 ± 6.4 min; p < .01), shorter radiofrequency duration (49 ± 16 vs. 282 ± 124 s; p < .01), fewer lesions (8.3 ± 2.5 vs. 10.4 ± 4.4; p < .01), and lower ablation index (316 ± 38 vs. 356 ± 62; p < .001) than the LPLD group. The incidence of a postprocedural asymptomatic mild diaphragmatic elevation was comparable (2% in the HPSD group vs. 6% in the LPLD group; p = .61). CONCLUSION: The 50-W HPSD ablation strategy allowed for a successful, fast, and safe SVCI with the fewer ablation lesions and the lower ablation index.
Kusa et al. (2021) conducted a cohort in Patients undergoing superior vena cava isolation (SVCI) (n=100). High-power, short-duration (HPSD) ablation vs. Conventional lower-power and longer-duration (LPLD) ablation (20-25 W for 20-30 s) was evaluated on Procedure time (minutes) (p=<.01). High-power, short-duration (50 W) ablation for superior vena cava isolation significantly reduced procedure time (10.8 vs 14.8 min; p<0.01) and radiofrequency duration compared to conventional ablation.