Novel protocol for optimal utilization of HPSD approach for pulmonary vein isolation

Scientific paper - Original scientific paper

• Author: Hayarpi Manukyan
• Author: Nandor Szegedi
• Author: Nikola Pavlović
• Author: Herman Blessberger
• Author: Lucas Fiedler
• Author: Konstantin Krieger
• Author: Šime Manola
• Author: Vivien K. Nagy
• Author: Franz Xaver Roithinger
• Author: Zoltán Salló
• Author: Clemens Steinwender
• Author: László Gellér
• Author: Guido A. Matschuck
• Author: Jedrzej Kosiuk
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Background: The efficiency of pulmonary vein isolation (PVI) depends on the durability of RF lesions. Recent studies documented sustained continuity of ablation lines, improvements in durability, and expected clinical outcomes through altered settings in duration and power. However, the ablation strategy has not been adapted to this new approach and different biophysics of lesion formation.

Purpose: The aim of this study was to demonstrate that by adjusting the ablation approach to the broader geometry of lesions by increasing the minimal spacing between adjacent RF, a further significant reduction of procedural time while maintaining sufficient long-term outcomes is achievable.

Methods: The presented study was a prospective, observational multi-center trial. The periprocedural data were compared with data from a consecutively collected historical cohort.

Results: In total, 196 patients were included (mean age 62 ± 11 years, male 64.3%). Procedural duration, RF time, and LA dwelling time were significantly shorter in the HPSD group compared with the standard group (73 ± 26 min vs. 98 ± 36 min, p < .001; 14 ± 7 min vs. 33 ± 12 min, p < .001; and 59 ± 21 min vs. 77 ± 32 min, p < .001, respectively). Mean AF-free survival in the first year of follow-up was 304 ± 14 days in the HPSD group versus 340 ± 10 days in the standard group (log-rank p = .403). There were no statistically significant differences in the complication rates between the groups.

Conclusion: Increasing the minimal distance between individual application points simplifies AF ablation and further reduces procedure time without negative effects on efficacy and safety. Larger studies are needed to optimally utilize this approach.

• Keywords (english): ablation; atrial fibrillation; high‐power short duration; pulmonary vein isolation
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Journal of Arrhythmia
• Numbering: vol. 39, no. 4, pp. 539-545
• p-ISSN: 1880-4276
• e-ISSN: 1883-2148
• DOI: https://doi.org/10.1002/joa3.12868
• URN:NBN: urn:nbn:hr:105:129502
• Publication: 2023-05-15
• Document URL: https://onlinelibrary.wiley.com/doi/10.1002/joa3.12868
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-09-02 08:40:11