Safety and effectiveness of very-high-power, short-duration ablation in patients with atrial fibrillation: Preliminary results

• Published in: Europace (London, England) England), 2023-05, Vol.25 (Supplement_1)
• Main Authors: Lodzinski, P, Mitrzak, K, Peller, M, Krzowski, B, Maciejewski, C, Balsam, P, Marchel, M, Grabowski, M
• Format: Article
• Language: English
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euad122.745

Abstract Funding Acknowledgements Type of funding sources: None. Background Pulmonary vein isolation (PVI) is at the forefront of rhythm control strategies in patients with atrial fibrillation (AF). A very-high-power, short-duration (vHPSD) catheter was designed to improve the effectiveness of AF ablation within a shorter procedure time. We aimed to compare the effectiveness and safety of PVI ablation between this vHPSD ablation mode (90W/4s) and conventional index-guided ablation (up to 40W/indexed). Methods This single-center, retrospective, observational study enrolled 148 patients with AF, referred for catheter ablation between December 16, 2019 and July 29, 2022. In 77 procedures (mean age: 59.7±12.0 years; 61.0% male; 74.0% paroxysmal), a vHPSD catheter was used (vHPSD-group), and 71 patients (mean age: 58.1±11.6 years; 70.4% male; 67.6% paroxysmal) were treated with a ablation index catheter (AI-group). The study assessed the recurrence of AF at 3- and 6-months after ablation. The outcomes also included the amount of opioids administered during the procedure and the incidence of treatment-emergent adverse events. Additionally, procedural factors, such as total procedure time, fluoroscopy time and radiofrequency application time were compared between the groups. Results At 3 months, AF was found to recur in 14.29% (11/77) of patients in the vHPSD-group and in 30.99% (22/71) of patients in the AI-group (p=0.02). At 6 months, 18.31% (13/71) patients reported AF recurrence in the vHPSD-group and 32.73 % (18/55) in the AI-group (p=0.09). There was no difference in treatment-emergent adverse events between the two groups (3.9% vs. 2.8%; p=1.00). One severe adverse event (a cerebral vascular accident) was observed in the vHPSD-group. The mean dose of remifentanil was reported to be lower during vHPSD-based PVI (p