Comparison of lesion characteristics between conventional and high-power short-duration ablation using contact force-sensing catheter in patients with paroxysmal atrial fibrillation

• Published in: BMC cardiovascular disorders Vol. 21; no. 1; p. 387
• Main Authors: Chen, Chun-Chao, Lee, Po-Tseng, Van Ba, Vu, Chuang, Chieh-Mao, Lin, Yenn-Jiang, Lo, Li-Wei, Hu, Yu-Feng, Chung, Fa-Po, Lin, Chin-Yu, Chang, Ting-Yung, Vicera, Jennifer Jeanne, Huang, Ting-Chun, Liu, Chih-Min, Wu, Cheng-I, Lugtu, Isaiah C, Jain, Ankit, Chang, Shih-Lin, Chen, Shih-Ann
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 09.08.2021; BioMed Central; BMC
• Subjects: Ablation; Ablation (Surgery); Age Factors; Anti-Arrhythmia Agents - therapeutic use; Atrial fibrillation; Atrial Fibrillation - drug therapy; Atrial Fibrillation - surgery; Cardiac arrhythmia; Care and treatment; Case-Control Studies; Catheter Ablation - instrumentation; Catheter Ablation - methods; Catheter Ablation - statistics & numerical data; Catheters; Comparative analysis; Contact force-guided ablation; Diagnosis; Electrophysiologic Techniques, Cardiac; Female; Fibrillation; Force time integral; High-power short-duration ablation; Humans; Lesions; Male; Methods; Middle Aged; Morphology; Operative Time; Patient outcomes; Pulmonary vein isolation; Pulmonary Veins - injuries; Pulmonary Veins - physiopathology; Recurrence; Sex Factors; Smart Materials; Statistical analysis; Time Factors; Treatment Outcome; Voltage; Taiwan; United States > US; High-power short-duration ablation; Atrial fibrillation; Force time integral; Voltage; Contact force-guided ablation; Pulmonary vein isolation
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-02196-y

Transmural lesion creation is essential for effective atrial fibrillation (AF) ablation. Lesion characteristics between conventional energy and high-power short-duration (HPSD) setting in contact force-guided (CF) ablation for AF remained unclear. Eighty consecutive AF patients who received CF with conventional energy setting (power control: 25-30 W, force-time integral = 400 g s, n = 40) or with HPSD (power control: 40-50 W, 10 s, n = 40) ablation were analyzed. Of them, 15 patients in each conventional and HPSD group were matched by age and gender respectively for ablation lesions analysis. Type A and B lesions were defined as a lesion with and without significant voltage reduction after ablation, respectively. The anatomical distribution of these lesions and ablation outcomes among the 2 groups were analyzed. 1615 and 1724 ablation lesions were analyzed in the conventional and HPSD groups, respectively. HPSD group had a higher proportion of type A lesion compared to conventional group (P < 0.01). In the conventional group, most type A lesions were at the right pulmonary vein (RPV) posterior wall (50.2%) whereas in the HPSD group, most type A lesions were at the RPV anterior wall (44.0%) (P = 0.04). The procedure time and ablation time were significantly shorter in the HPSD group than that in the conventional group (91.0 ± 12.1 vs. 124 ± 14.2 min, P = 0.03; 30.7 ± 19.2 vs. 57.8 ± 21 min, P = 0.02, respectively). At a mean follow-up period of 11 ± 1.4 months, there were 13 and 7 patients with recurrence in conventional and HPSD group respectively (P = 0.03). Optimal ablation lesion characteristics and distribution after conventional and HPSD ablation differed significantly. HPSD ablation had shorter ablation time and lower recurrence rate than did conventional ablation.