학술논문
Novel protocol for optimal utilization of HPSD approach for pulmonary vein isolation
Document Type
Clinical report
Author
Source
Journal of Arrhythmia. August 2023, Vol. 39 Issue 4, p539, 7 p.
Subject
Language
English
ISSN
1880-4276
Abstract
INTRODUCTION Pulmonary vein isolation (PVI) has been established as the cornerstone for the invasive treatment of atrial fibrillation (AF).[sup.1,2] Successful ablation outcome requires durable lesion formation, which is the predominant [...]
: 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 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.
: 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 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.