Pulmonary vein isolation durability after very high-power short-duration ablation utilizing a very-close protocol – The FAST AND FURIOUS redo study

Heeger, Christian-H.; Subin, Behnam; Eitel, Charlotte; Ștefan Popescu, Sorin; Phan, Huong-Lan; Mamaev, Roman; Bartoli, Lorenzo; Große, Niels; Reincke, Samuel; Traub, Anna; Lopez, Delgado; Kirstein, Bettina; Hatahet, Sascha; Kuck, Karl-Heinz; Vogler, Julia; Tilz, Roland R.

doi:10.1016/j.ijcha.2023.101325

Cited by 5 publications

(1 citation statement)

References 27 publications

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“…In addition, with the application of a novel QDOT MICRO catheter, the first and only temperature‐controlled CF‐sensing catheter with 2 mode ablation for procedural flexibility and 6 thermocouples monitoring real‐time temperature, the very high‐power short‐duration mode (90 W/4 s) was applied to minimize conductive heating and increase resistive heating. 7 , 17 As far as current vitro studies and small sample clinical studies, 24 , 25 , 26 the results of mode are attractive, via “close protocol” provide faster, safer and more effective acute PVI, but the long‐term safety and efficacy result of this ablation mode needs to be further explored.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome of high‐power ablation guided by ablation index in the treatment of atrial fibrillation

Mao,

Wang,

Fan

et al. 2024

Journal of Arrhythmia

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ObjectiveHigh‐power ablation has been widely used in atrial fibrillation (AF). However, there were many studies observed the outcomes of the short‐term follow‐up. This study aims to the long‐term results of high‐power ablation guided by ablation index (AI) in patients with AF.MethodsAnalysis of patients with AF, who first received high‐power (40–50 W) ablation, to pulmonary vein isolation (PVI) in the Second Hospital of Shanxi Medical University from May 2020 to March 2022. All patients were managed perioperatively according to the routine treatment procedures. High‐power ablation was conducted under the guidance of our conventional power AI and baseline data, first‐pass PVI rate, ablation time, operative time, and long‐term surgical success rate were analyzed.ResultsA total of 83 patients with atrial fibrillation were enrolled in the study, with an average age of 61.62 ± 9.04 years, 47 male patients, and 49 paroxysmal atrial fibrillation. All patients achieved PVI, and the rate of first pass was 82%. The ablation time of the left atrial was 28.54 ± 9.11 min. There were no serious complications related to ablation, and only a small amount of pericardial effusion was found in 4 patients. During the follow‐up period of 26.36 ± 6.11 months, 8 patients were lost to follow‐up and the overall success rate was 84%, including 91% for paroxysmal AF and 71% for persistent AF.ConclusionHigh‐power ablation long‐term results appear a high freedom atrial arrhythmia, but further expanded samples are needed for controlled studies.

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Section: Discussionmentioning

confidence: 99%

Long‐term outcome of high‐power ablation guided by ablation index in the treatment of atrial fibrillation

Mao,

Wang,

Fan

et al. 2024

Journal of Arrhythmia

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Where is the gap after a 90 W/4 s very‐high‐power short‐duration ablation of atrial fibrillation?: Association with the left atrial‐pulmonary vein voltage and wall thickness

Hirata,

Nagashima,

Watanabe

et al. 2024

Journal of Arrhythmia

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BackgroundAlthough pulmonary vein isolation (PVI) for atrial fibrillation (AF) utilizing radiofrequency (RF) applications with a very high‐power and short‐duration (vHPSD) has shortened the procedure time, the determinants of pulmonary vein (PV) gaps in the first‐pass PVI and acute PV reconnections are unclear.MethodsAn extensive encircling PVI was performed with the QDOT MICRO catheter with a vHPSD (90 W–4 s) in 30 patients with AF (19 men, 64 ± 10 years). The association of the PV gap sites (first‐pass PVI failure, acute PV reconnections [spontaneous reconnections or dormant conduction provoked by adenosine triphosphate] or both) with the left atrial (LA) wall thickness and LA bipolar voltage on the PVI line and ablation‐related parameters were assessed.ResultsPV gaps were observed in 29 (6%) of 480 segments (16 segments per patient) in 17 patients (56%). The PV gaps were associated with the LA wall thickness, bipolar voltage, and the number of RF points (LA wall thickness, 2.5 ± 0.5 vs. 1.9 ± 0.4 mm, p < .001; bipolar voltage, 2.59 ± 1.62 vs. 1.34 ± 1.14 mV, p < .001; RF points, 6 ± 2 vs. 4 ± 2, p = .008) but were not with the other ablation‐related parameters. Receiver operating characteristic curves yielded that an LA wall thickness ≥2.3 mm and bipolar voltage ≥2.40 mV were determinants of PV gaps with an area under the curve of 0.82 and 0.73, respectively.ConclusionsThe LA voltage and wall thickness on the PV‐encircling ablation line were highly associated with PV gaps using the 90 W/4 s‐vHPSD ablation.

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Editorial to: Where is the gap after a 90 W/4 s very high‐power short‐duration ablation of atrial fibrillation?: Association with the left atrial‐pulmonary vein voltage and wall thickness

Heeger,

Kuck,

Tilz

2024

Journal of Arrhythmia

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Pulmonary vein isolation durability after very high-power short-duration ablation utilizing a very-close protocol – The FAST AND FURIOUS redo study

Cited by 5 publications

References 27 publications

Long‐term outcome of high‐power ablation guided by ablation index in the treatment of atrial fibrillation

Long‐term outcome of high‐power ablation guided by ablation index in the treatment of atrial fibrillation

Where is the gap after a 90 W/4 s very‐high‐power short‐duration ablation of atrial fibrillation?: Association with the left atrial‐pulmonary vein voltage and wall thickness

Editorial to: Where is the gap after a 90 W/4 s very high‐power short‐duration ablation of atrial fibrillation?: Association with the left atrial‐pulmonary vein voltage and wall thickness

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