Radiofrequency ablation of atrial fibrillation - 50 W or 90 W?: original articles
Background: This study sought to evaluate the short and midterm efficacy and safety of the novel very high power very short duration (vHPvSD) 90 W approach compared to HPSD 50 W for atrial fibrillation (AF) ablation as well as reconnection patterns of 90 W ablations. Methods and Results: Consecutive...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
19 September 2022
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| In: |
Journal of cardiovascular electrophysiology
Year: 2022, Volume: 33, Issue: 12, Pages: 2504-2513 |
| ISSN: | 1540-8167 |
| DOI: | 10.1111/jce.15681 |
| Online Access: | Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.1111/jce.15681 Verlag, lizenzpflichtig, Volltext: http://onlinelibrary.wiley.com/doi/abs/10.1111/jce.15681 
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| Author Notes: | Julian Mueller, Karin Nentwich, Elena Ene, Artur Berkovitz, Kai Sonne, Ivaylo Chakarov, Sebastian Barth, Christian Waechter, Michael Behnes, Ibrahim Akin, Philipp Halbfass, Thomas Deneke |
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| 245 | 1 | 0 | |a Radiofrequency ablation of atrial fibrillation - 50 W or 90 W? |b original articles |c Julian Mueller, Karin Nentwich, Elena Ene, Artur Berkovitz, Kai Sonne, Ivaylo Chakarov, Sebastian Barth, Christian Waechter, Michael Behnes, Ibrahim Akin, Philipp Halbfass, Thomas Deneke |
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| 520 | |a Background: This study sought to evaluate the short and midterm efficacy and safety of the novel very high power very short duration (vHPvSD) 90 W approach compared to HPSD 50 W for atrial fibrillation (AF) ablation as well as reconnection patterns of 90 W ablations. Methods and Results: Consecutive patients undergoing first AF ablation with vHPvSD (90 W; predefined ablation time of 3 s for posterior wall ablation and 4 s for anterior wall ablation) were compared to patients using HPSD (50 W; ablation index-guided; AI 350 for posterior wall ablation, AI 450 for anterior wall ablation) retrospectively. A total of 84 patients (67.1 ± 9.8 years; 58% male; 47% paroxysmal AF) were included (42 with 90 W, 42 with 50 W) out of a propensity score-matched cohort. 90 W ablations revealed shorter ablation times (10.5 ± 6.7 min vs. 17.4 ± 9.9 min; p = .001). No major complication occurred. 90 W ablations revealed lower first pass PVI rates (40% vs. 62%; p = .049) and higher AF recurrences during blanking period (38% vs. 12%; p = .007). After 12 months, both ablation approaches revealed comparable midterm outcomes (62% vs. 70%; log-rank p = .452). In a multivariable Cox regression model, persistent AF (hazard ratio [HR]: 1.442, 95% confidence interval [CI]: 1.035-2.010, p = .031) and increased procedural duration (HR: 1.011, 95% CI: 1.005-1.017, p = .001) were identified as independent predictors of AF recurrence during follow-up. Conclusions: AF ablation using 90 W vHPvSD reveals a similar safety profile compared to 50 W ablation with shorter ablation times. However, vHPvSD ablation was associated with lower rates of first-pass isolations and increased AF recurrences during the blanking period. After 12 months, 90 W revealed comparable efficacy results to 50 W ablations in a nonrandomized, propensity-matched comparison. | ||
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