Very high-power short-duration temperature-controlled ablation versus conventional power-controlled ablation for pulmonary vein isolation: The fast and furious - AF study.
Very high-power short-duration temperature-controlled ablation versus conventional power-controlled ablation for pulmonary vein isolation: The fast and furious - AF study.
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DOI：
10.1016/j.ijcha.2021.100847
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Heeger CH
中科院分区：
文献类型：
--
作者：
Richard Tilz R;Sano M;Vogler J;Fink T;Saraei R;Sciacca V;Kirstein B;Phan HL;Hatahet S;Delgado Lopez L;Traub A;Eitel C;Schlüter M;Kuck KH;Heeger CH
用于房颤（AF）治疗的导管消融可提供有效且持久的肺静脉隔离（PVI），并与令人鼓舞的临床结局相关。一种新型的CF感知温控射频（RF）消融导管允许进行非常高功率的短时间（vHP-SD，90 W/4 s）消融，旨在实现更安全、更有效和更快的消融。我们考虑评价使用新型vHP-SD导管进行vHP-SD消融治疗肺静脉隔离的初步安全性和有效性。将该数据与使用传统压力感应（CF）导管的传统功率控制消融指数（AI）引导肺静脉隔离进行比较。本研究前瞻性入组了五十六例阵发性或持续性房颤患者。28名连续患者接受了基于vHP-SD的肺静脉隔离（vHP-SD组），并与28名使用AI的传统CF感知导管治疗的连续患者（对照组）进行了比较。使用vHP-SD成功分离了所有PV。vHP-SD的中位射频消融时间为338（IQR 286，367）秒，对照组为1580（IQR 1350，1848）秒（p < 0.0001），中位手术持续时间为vHP-SD 55（IQR 48-60）分钟，对照组为105（IQR 92-120）分钟（p < 0.0001）。围手术期并发症无差异。新型vHP-SD消融模式的初步数据提供了安全有效的肺静脉隔离。与对照组相比，vHP-SD组的手术持续时间和射频消融时间显著缩短。
Catheter ablation for atrial fibrillation (AF) treatment provides effective and durable pulmonary vein isolation (PVI) and is associated with encouraging clinical outcome. A novel CF sensing temperature-controlled radiofrequency (RF) ablation catheter allows for very high-power short-duration (vHP-SD, 90 W/4 s) ablation aiming a potentially safer, more effective and faster ablation. We thought to evaluate preliminary safety and efficacy of vHP-SD ablation for PVI utilizing a novel vHP-SD catheter. The data was compared to conventional power-controlled ablation index (AI) guided PVI utilizing conventional contact force (CF) sensing catheters. Fifty-six patients with paroxysmal or persistent AF were prospectively enrolled in this study. Twenty-eight consecutive patients underwent vHP-SD based PVI (vHP-SD group) and were compared to 28 consecutive patients treated with conventional CF-sensing catheters utilizing the AI (control group). All PVs were successfully isolated using vHP-SD. The median RF ablation time for vHP-SD was 338 (IQR 286, 367) seconds vs control 1580 (IQR 1350, 1848) seconds (p < 0.0001), the median procedure duration was vHP-SD 55 (IQR 48–60) minutes vs. control 105 (IQR 92–120) minutes (p < 0.0001). No differences in periprocedural complications were observed. This preliminary data of the novel vHP-SD ablation mode provides safe and effective PVI. Procedure duration and RF ablation time were substantially shorter in the vHP-SD group in comparison to the control group.
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