Impedance drop predicts acute electrical reconnection of the pulmonary vein-left atrium after pulmonary vein isolation using short-duration high-power exposure

Yazaki, Kyoichiro; Ejima, Koichiro; Kanai, Miwa; Kataoka, Shohei; Higuchi, Satoshi; Daigo, Yataro; Shoda, Morio; Hagiwara, Nobuhisa

doi:10.1007/s10840-019-00691-z

Cited by 33 publications

(72 citation statements)

References 19 publications

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“…Ten studies from 2006 to 2020 involving 2274 patients were included (1393 patients underwent HPSD strategy and 881 patients underwent LPLD strategy) 10,15–22,27 . There were six in the prospective cohort and three in the retrospective cohort and one RCT.…”

Section: Resultsmentioning

confidence: 99%

“…This finding is not overly surprising as, among the nine studies that reported 1-year freedom from AT, six studies did not demonstrate a statistically significant difference in outcomes when comparing the two ablation strategies. 10,15,16,19,21,22 However, in the subgroup analysis of the only included RCT by Leo et al, 27 T A B L E 1 Study characteristics of included studies in the meta-analysis F I G U R E 4 Forest plot of the included studies comparing fluoroscopy time between high-power, short-duration (HPSD) strategy and lowpower, long-duration (LPLD) strategy. 95% CI, 95% confidence interval; WMD, weighted mean difference F I G U R E 5 Forest plot of the included studies comparing risk of complications between high-power, short-duration (HPSD) strategy and lowpower, long-duration strategy; (A) Esophageal ulcer and arterioesophageal fistula.…”

Section: Discussionmentioning

confidence: 99%

“…Ten studies from 2006 to 2020 involving 2274 patients were included (1393 patients underwent HPSD strategy and 881 patients underwent LPLD strategy). 10,[15][16][17][18][19][20][21][22]27 There were six in the…”

Section: Description Of Included Studiesmentioning

confidence: 99%

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High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis

Kewcharoen

Techorueangwiwat

Kanitsoraphan

et al. 2020

Cardiovasc electrophysiol

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Background: Multiple strategies have advocation for power titration and catheter movement during atrial fibrillation (AF) ablation. Comparative favoring evidence regarding the efficacy, logistics, and safety of a higher-power, shorter duration (HPSD) ablation strategy compared to a lower-power, longer duration (LPLD) ablation strategy is insubstantial. We performed a meta-analysis to compare arrhythmia-free survival, procedure times, and complication rates between the two strategies.Methods: We searched MEDLINE, EMBASE, and Cochrane Library from inception to September 2020. We included studies comparing patients who underwent HPSD and LPLD strategies for AF ablation and reporting either of the following outcomes:Freedom from atrial tachyarrhythmia (AT) including AF and atrial flutter, procedure time, or periprocedural complications. We combined data using the random-effects model to calculate the odds ratio (OR) and weight mean difference (WMD) with a 95% confidence interval (CI).Results: Ten studies from 2006 to 2020 involving 2274 patients were included (1393 patients underwent HPSD strategy and 881 patients underwent LPLD strategy). HPSD strategy was not associated with increased freedom from AT at 12-month follow-up (OR = 1.54, 95% CI: 0.99 to 2.40, p = .054). In the subgroup analysis of the randomized controlled trial, the HPSD strategy was associated with

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis

Kewcharoen

Techorueangwiwat

Kanitsoraphan

et al. 2020

Cardiovasc electrophysiol

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“…Six of ten were prospective studies [17][18][19][20][21]23 , and one was RCT. 21 The meta-regression analysis Castrejón-Castrejón 8,16,18,21,24 All studies had good methodological qualities. The grouping results ensured the feasibility of this meta-analysis.…”

Section: Study Characteristicsmentioning

confidence: 99%

Comparison of high‐power short‐duration and low‐power long‐duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta‐analysis

Chen

Jin

et al. 2020

Clinical Cardiology

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Background: High power shorter duration (HPSD) ablation seen to increase efficacy and safety treating of atrial fibrillation (AF); however, comparative data between HPSD and low power longer duration (LPLD) ablation are limited. Hypothesis: We thought that HPSD might bring more clinical benefits. The aim of this meta-analysis was to evaluate the clinical benefits of HPSD in patients with AF. Methods: The Medline, PubMed, Embase, and the Cochrane Library databases were searched for studies comparing HPSD and LPLD ablation. Results: Ten trials with 2467 patients were included in the analysis. Pooled analyses demonstrated that HPSD showed a benefit of first-pass pulmonary vein isolation (PVI) (risk ratio [RR]: 1.20; 95% confidence interval [

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“…A significant difference in power delivery setting was found between the HPSD and LPLD groups. There is no consensus about the power and duration settings for HPSD, in our study, energy levels above 40 W are considered as high power and duration of application for 2˜10s as short duration 4,13,14,[17][18][19][20] . All patients received PVI, additional linear ablations were performed in select patients at the operator's discretion in some trials 4,18,19 .…”

Section: Study Characteristicsmentioning

confidence: 99%

Safety and Efficacy of High Power Shorter duration Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

Chen

et al. 2020

Preprint

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Background: Radiofrequency ablation in patients with atrial fibrillation (AF) is effective but hampered by pulmonary veins reconnection due to insufficient lesions. High power shorter duration ablation (HPSD) seen to increase efficacy and safety. This analysis aimed to evaluate the clinical benefits of HPSD in patients with AF. Methods: The Medline, PubMed, Embase, and the Cochrane Library databases were searched for studies comparing HPSD and Low power longer duration (LPLD) ablation. Results: A total of seven trials with 2023 patients were included in the analysis. Pooled analyses demonstrated that HPSD showed a benefit of first-pass pulmonary vein isolation (PVI) [

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Impedance drop predicts acute electrical reconnection of the pulmonary vein-left atrium after pulmonary vein isolation using short-duration high-power exposure

Cited by 33 publications

References 19 publications

High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis

High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis

Comparison of high‐power short‐duration and low‐power long‐duration radiofrequency ablation for treating atrial fibrillation: Systematic review and meta‐analysis

Safety and Efficacy of High Power Shorter duration Ablation for Atrial Fibrillation: A Systematic Review and Meta-Analysis.

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