Comparison of higher-power and conventional power ablation of atrial fibrillation using contact force-sensing catheters: a systematic review and meta-analysis

Cui, Luqian; Chu, Yongchao; Han, Yongmei; Dong, Shujuan

doi:10.1007/s10840-021-00975-3

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…This meta-analysis provides a more comprehensive assessment of HPSD RFA and conventional RFA in patients with AF. As in the previous studies [ 8 , 9 , 33 , 34 ], our results suggest that HPSD RFA may be more effective with higher first-pass isolation and freedom from atrial arrhythmia and lower acute PVR when compared with conventional RFA. Additionally, there was no difference in safety outcomes between the two groups.…”

Section: Discussionsupporting

confidence: 87%

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Jin

Jiang

et al. 2022

Journal of Interventional Cardiology

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Aim. We aimed to evaluate the effectiveness and safety between high-power short-duration (HPSD) radiofrequency ablation (RFA) and conventional RFA in patients with atrial fibrillation (AF). Methods. Studies comparing HPSD and traditional applications in patients undergoing initial catheter ablation for atrial fibrillation from inception through December 2021 were searched on Pubmed, Medline, Cochrane, and Clinicaltrials.gov. Results. The meta-analysis included seventeen studies with a total of 4934 patients. HPSD group decreased procedure duration (mean difference (MD) −38.28 min, P < 0.001 ), RF duration (MD −20.51 min, P < 0.001 ), fluoroscopy duration (MD −5.19 min, P < 0.001 ), and acute pulmonary vein reconnection (Odds ratio (OR) 0.40, P < 0.001 ), while improving the freedom from atrial arrhythmia at one year (OR 1.48, 95% confidence interval (CI) 1.12–1.94, P = 0.005 ) and rates of first-pass isolation (OR 8.92, P = 0.001 ). Compared with the conventional group, freedom from atrial arrhythmia at one-year follow-up was higher in the HPSD group without the guidance of AI/LSI (OR 1.66, P = 0.01 ) and studies with a power setting of 40–50 W (OR 1.93, P = 0.002 ). Nevertheless, the two groups had similar effectiveness with a power setting of 50 W in the HPSD RFA (OR 1.10, P = 0.52 ). There was no difference in complications between the two groups ( P = 0.71 ). Conclusion. HPSD RFA was associated with shorter procedure duration, higher freedom from atrial arrhythmia, and comparable safety compared to conventional RFA.

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Section: Discussionsupporting

confidence: 87%

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Jin

Jiang

et al. 2022

Journal of Interventional Cardiology

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“…The objective of ablation is to produce transmural lesions while minimizing collateral damage to important structures. A high-power ablation strategy for PVI has been demonstrated to create contiguous and durable RF lesions without compromise on complications in several studies (1)(2)(3)(4)(5)(6). The delivered energy causes lesions through a combination of resistive and conductive heating phases.…”

Section: Ablation Index-guided High-power Ablationmentioning

confidence: 99%

“…In recent years, there has been a growing interest in the highpower ablation strategy (1)(2)(3)(4)(5)(6). The ablation index (AI), which weighs contact force (CF), radiofrequency time, and applied power, has been shown to aid in the creation of long-lasting ablation lesions (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Ablation index-guided high-power ablation for superior vena cava isolation in patients with atrial fibrillation

Cui

Dong

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe strategy of ablation index (AI)-guided high-power ablation seems to be a novel strategy for performing pulmonary vein isolation (PVI). An AI-guided high-power ablation strategy was used in this study to determine whether superior vena cava isolation (SVCI) after PVI was feasible and safe for patients with AF.MethodsData from 53 patients with AF were collected. Mapping and ablation of SVC were performed. The applied power was set at 45 W and the procedure was guided by AI. The SVC was divided into six segments in a cranial view. The RF applications and AI values in different segments were compared and analyzed. Using receiver operating characteristic (ROC) analysis, the diagnostic accuracy of AI value for predicting segment block was evaluated.ResultsElectrical SVCIs were successfully achieved in all patients. SVCI was performed by segment ablation in most cases, with RF applications in different segments. The mean AI value in non-lateral walls was higher than that of the lateral wall (392 ± 28 vs. 371 ± 37, P < 0.001). Acutely blocked sites had significantly larger AI values compared with no-blocked sites (390 ± 30 vs. 343 ± 23, P < 0.001). The optimal AI cut-off value for non-lateral segments was 379 (sensitivity: 75.9%, specificity: 100%) and for lateral segments was 345 (sensitivity: 82.3%, specificity: 100%).ConclusionThe AI values were predictive of the acute conduction block of SVCI. With AI values of 345 and 379, respectively, conduction block was achieved in the lateral walls at a lower level than in the non-lateral walls.

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Outcomes of catheter ablation versus antiarrhythmic therapy in patients with atrial fibrillation: a systematic review and meta-analysis

Deshpande

Al‐Khadra

Singanallur

et al. 2022

J Interv Card Electrophysiol

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Comparison of higher-power and conventional power ablation of atrial fibrillation using contact force-sensing catheters: a systematic review and meta-analysis

Cited by 5 publications

References 20 publications

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Comparison of Effectiveness and Safety between High-Power Short-Duration Ablation and Conventional Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Ablation index-guided high-power ablation for superior vena cava isolation in patients with atrial fibrillation

Outcomes of catheter ablation versus antiarrhythmic therapy in patients with atrial fibrillation: a systematic review and meta-analysis

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