Very high-power short-duration temperature-controlled ablation versus
conventional ablation-index guided power-controlled ablation for
pulmonary vein isolation
Abstract
Background: Catheter ablation for atrial fibrillation (AF) treatment
provides effective and durable pulmonary vein isolation (PVI) and is
associated with encouraging clinical outcome. A novel CF sensing
temperature-controlled radiofrequency (RF) ablation catheter allows for
very high-power short-duration (vHP-SD, 90W/4 seconds) ablation aiming a
potentially safer, more effective and faster ablation. We thought to
evaluate preliminary safety and efficacy of vHP-SD ablation for PVI
utilizing a novel vHP-SD catheter. The data was compared to conventional
power-controlled ablation index (AI) guided PVI utilizing conventional
contact force (CF) sensing catheters. Methods and Results: Fifty-six
patients with paroxysmal or persistent AF were prospectively enrolled in
this study. Twenty-eight consecutive patients underwent vHP-SD based PVI
(vHP-SD group) and were compared to 28 consecutive patients treated with
conventional CF-sensing catheters utilizing the AI (control group). All
PVs were successfully isolated using vHP-SD. The median RF ablation time
for vHP-SD was 338 (IQR 286, 367) seconds vs control 1580 (IQR 1350,
1848) seconds (p<0.0001), the median procedure duration was
vHP-SD 55 (IQR 48-60) minutes vs. control 105 (IQR 92-120) minutes
(p<0.0001). No differences in periprocedural complications
were observed. Conclusions: This preliminary data of the novel vHP-SD
ablation mode provides safe and effective PVI. Procedure duration and RF
ablation time were substantially shorter in the vHP-SD group in
comparison to the control group.