Outcome of High-power Short-duration Radiofrequency Ablation in
Combination with Half-Normal Saline Irrigation for the Treatment of
Atrial Fibrillation
Abstract
ABSTRACT Background: Data regarding the use of high-power short-duration
(HPSD) radiofrequency (RF) in combination with half-normal saline
irrigation for catheter irrigation is limited. Objectives: This study
investigated the safety and efficacy of using HPSD RF ablation in
combination with half-normal saline irrigation for the treatment of AF.
Methods: One hundred consecutive patients with AF underwent RF ablation
using HPSD combined with half-normal saline for catheter irrigation. In
addition, the following ablation strategies were used: 1 mm tags for the
display of ablation lesions on the mapping system, high-frequency jet
ventilation (HFJV), low contact force, pacing after ablation to verify
areas of noncapture, atrial/ventricular pacing at 500 to 700 ms to aid
in catheter stability, use of two skin electrodes to reduce impedance,
and post-ablation adenosine infusion. Power was started at 40-45 W and
was modulated manually based on impedance changes. Results: The average
age of patients was 65.2 years and 70% were male. Forty-seven percent
had paroxysmal AF and the average CHA2DS2-VASc score was 2.1±1.6. The
average power and lesion duration were 38.1 ± 3.3 W and 8.1 ± 2.3
seconds, respectively. During a median follow-up period of 321 + 139
days, 89% of the patients remained free from any atrial arrhythmias
after a single RF ablation procedure. No procedure-related death,
stroke, pericardial effusion, or atrioesophageal fistula occurred during
follow-up. Conclusions: Catheter ablation using HPSD RF lesions in
combination with half-normal saline irrigation and is safe and
effective, and results in high rate of freedom from AF.