Honarbakhsh, Shohreh;
Martin, Claire A;
Dhillon, Gurpreet;
Gallagher, Mark;
Sohal, Manav;
Chow, Anthony;
Ahsan, Syed;
... Hunter, Ross J; + view all
(2023)
Contact force and catheter stability are predictive metrics of successful pulmonary vein isolation with high-power short duration ablation in atrial fibrillation.
Journal of Cardiovascular Electrophysiology
, 34
(5)
pp. 1141-1151.
10.1111/jce.15867.
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Cardiovasc electrophysiol - 2023 - Honarbakhsh - Contact force and catheter stability are predictive metrics of successful.pdf - Accepted Version Download (655kB) | Preview |
Abstract
INTRODUCTION: Preliminary data suggest that high power short duration (HPSD) ablation for pulmonary vein isolation (PVI) are safe. Limited data are available on its effectiveness. Aim was to evaluate HPSD ablation in AF ablation using a novel Qdot Micro catheter. METHODS AND RESULTS: Prospective multi-centre study evaluating safety and efficacy of PVI with HPSD ablation. First pass isolation (FPI) and sustained PVI was assessed. If FPI was not achieved additional ablation index (AI)-guided ablation with 45W was performed and metrics predictive of this were determined. Sixty-five patients and 260 veins were treated. Procedural and LA dwell time was 93.9±30.4 and 60.5±23.1 minutes respectively. FPI was achieved in 47 (72.3%) patients and 231 veins (88.8%) with an ablation duration of 4.6±1.0 minutes. Twenty-nine veins required additional AI-guided ablation to achieve initial PVI with 24 anatomical sites ablated with the right posterior carina being the most common site (37.5%). A contact force of ≥8g (AUC 0.81; p<0.001) and catheter position variation of ≤1.2mm (AUC 0.79; p<0.001) with HPSD were strongly predictive of not requiring additional AI-guided ablation. Out of the 260 veins, only 5 (1.9%) veins showed acute reconnection. HPSD ablation was associated with shorter procedure times (93.9min vs.159.4min; p<0.001), ablation times (6.1min vs. 27.7min; p<0.001) and lower rates of PV reconnection (9.2% vs. 30.8%; p=0.004) compared to moderate power cohort. CONCLUSIONS: HPSD ablation is an effective ablation modality which results in effective PVI whilst maintaining a safety profile. Its superiority needs to be evaluated in randomised controlled trials. This article is protected by copyright. All rights reserved.
| Type: | Article |
|---|---|
| Title: | Contact force and catheter stability are predictive metrics of successful pulmonary vein isolation with high-power short duration ablation in atrial fibrillation |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/jce.15867 |
| Publisher version: | https://doi.org/10.1111/jce.15867 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Atrial fibrillation, Novel technology, Pulmonary vein isolation, Radiofrequency ablation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10166253 |
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