Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-158 - Left Atrial Substrate Modification In Persistent Atrial Fibrillation Using High Power Short Duration Ablation Compared To A Standard Ablation Protocol - Procedural Characteristics And Intraprocedural Af Termination (ID 1129)


Background: In patients with persistent atrial fibrillation (PAF) different left atrial substrate modification protocols besides pulmonary vein isolation (PVI) failed to satisfy. An explanation could be that those results are hampered by tissue recovery due to created tissue edema. High power short duration (HPSD) ablation leads to less tissue edema. We therefore compared PVI plus ablation of complex fractionated electrograms (CFE) using HPSD ablation with standard ablation.
Methods: We included 182 patients with PAF that underwent ablation (NaVX/Flexability) using a modified stepwise approach with PVI plus CFE ablation. In n=110 patients (HPSD-group) an ablation protocol with 70 watts for 5-7 seconds was used. In n=72 patients (standard-group) a conventional protocol was used (30-40Watts/20-40 seconds).
Results: Baseline characteristics of patients are shown in table 1. Mean radiofrequency (RF) time and procedural time where significantly shorter in the HPSD-group compared to the standard-group with 134.9 ± 43.7 min vs. 173.7 ± 45.2 min (procedural time) and 29.1 ± 4.4 min vs. 64.3 ± 19.9min (RF time) (both p<0.001)(table 2). There was no significant difference in terms of intraprocedural complications (table 3). Termination of AF into AT was not significantly different (p=1.0).
Conclusion: HPSD ablation showed a similar safety profile compared to ablation using conventional power settings.
HPSD ablation lead to a dramatic reduction of RF and procedural time. Intraprocedural termination into AT was comparable between groups. Results in terms of freedom from AF are pending and will answer the question if CFE ablation using HPSD is more efficient.