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Original Article
Submitted: 2022-08-30
Accepted: 2022-11-25
Published online: 2022-12-29
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Safety and effectiveness of very-high-power, short-duration ablation in patients with atrial fibrillation: Preliminary results

Karolina Mitrzak1, Michał Peller1, Bartosz Krzowski1, Cezary Maciejewski1, Paweł Balsam1, Michał Marchel1, Marcin Grabowski1, Piotr Lodziński1
DOI: 10.5603/CJ.a2022.0118
·
Pubmed: 36588315
Affiliations
  1. 1st Department of Cardiology, Medical University of Warsaw, Poland

open access

Ahead of print
Original articles
Submitted: 2022-08-30
Accepted: 2022-11-25
Published online: 2022-12-29

Abstract

Background: Pulmonary vein isolation (PVI) is at the forefront of rhythm control strategies in patients with atrial fibrillation (AF). A very-high-power, short-duration (vHPSD) catheter, QDot MicroTM (Biosense Webster) was designed to improve the effectiveness of AF ablation within a shorter procedure time. The aim of this study was to compare the effectiveness and safety of PVI ablation between this vHPSD ablation mode and conventional ablation-index-guided ablation (ThermoCool Smarttouch SF catheter).

Methods: This single-center, retrospective, observational study enrolled 108 patients with AF, referred for catheter ablation between December 16, 2019 and December 3, 2021. In 54 procedures (mean age: 58.0 ± 12.3; 66.67% male), a QDot MicroTM catheter was used (vHPSD-group), and 54 patients (mean age: 57.2 ± 11.8; 70.37% male) were treated with a ThermoCool SmarttouchTM SF catheter (AI-group). The primary endpoint was freedom from AF 3 months after ablation.

Results: Atrial fibrillation was found to recur in 14.81% of patients in the vHPSD-group and in 31.48% of patients in the AI-group (p = 0.07). There was no difference in treatment-emergent adverse events between the two groups (6.3% vs. 0%; p = 0.10). One severe adverse event (a cerebral vascular accident) was observed in the vHPSD-group. The mean dose of remifentanil was reported to be lower during QDot MicroTM catheter-based PVI (p < 0.01). The vHPSD-based PVI was associated with shorter radiofrequency application time (p < 0.001), fluoroscopy time (p < 0.0001), and total procedure time (p < 0.0001).

Conclusions: This study suggests vHPSD ablation is safe, can reduce the dosage of analgesics during significantly shorter procedures and may enhance the success rate of catheter-based PVI.

Abstract

Background: Pulmonary vein isolation (PVI) is at the forefront of rhythm control strategies in patients with atrial fibrillation (AF). A very-high-power, short-duration (vHPSD) catheter, QDot MicroTM (Biosense Webster) was designed to improve the effectiveness of AF ablation within a shorter procedure time. The aim of this study was to compare the effectiveness and safety of PVI ablation between this vHPSD ablation mode and conventional ablation-index-guided ablation (ThermoCool Smarttouch SF catheter).

Methods: This single-center, retrospective, observational study enrolled 108 patients with AF, referred for catheter ablation between December 16, 2019 and December 3, 2021. In 54 procedures (mean age: 58.0 ± 12.3; 66.67% male), a QDot MicroTM catheter was used (vHPSD-group), and 54 patients (mean age: 57.2 ± 11.8; 70.37% male) were treated with a ThermoCool SmarttouchTM SF catheter (AI-group). The primary endpoint was freedom from AF 3 months after ablation.

Results: Atrial fibrillation was found to recur in 14.81% of patients in the vHPSD-group and in 31.48% of patients in the AI-group (p = 0.07). There was no difference in treatment-emergent adverse events between the two groups (6.3% vs. 0%; p = 0.10). One severe adverse event (a cerebral vascular accident) was observed in the vHPSD-group. The mean dose of remifentanil was reported to be lower during QDot MicroTM catheter-based PVI (p < 0.01). The vHPSD-based PVI was associated with shorter radiofrequency application time (p < 0.001), fluoroscopy time (p < 0.0001), and total procedure time (p < 0.0001).

Conclusions: This study suggests vHPSD ablation is safe, can reduce the dosage of analgesics during significantly shorter procedures and may enhance the success rate of catheter-based PVI.

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Keywords

ablation, pulmonary vein isolation, atrial fibrillation, vHPSD, QDot MicroTM

About this article
Title

Safety and effectiveness of very-high-power, short-duration ablation in patients with atrial fibrillation: Preliminary results

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2022-12-29

Page views

257

Article views/downloads

160

DOI

10.5603/CJ.a2022.0118

Pubmed

36588315

Keywords

ablation
pulmonary vein isolation
atrial fibrillation
vHPSD
QDot MicroTM

Authors

Karolina Mitrzak
Michał Peller
Bartosz Krzowski
Cezary Maciejewski
Paweł Balsam
Michał Marchel
Marcin Grabowski
Piotr Lodziński

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