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Journal of Interventional Cardiac Electrophysiology

Erschienen in:

16.08.2023

High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force–sensing catheters

verfasst von: Antonio Dello Russo, Leonardo D’Angelo, Paolo Compagnucci, Laura Cipolletta, Quintino Parisi, Yari Valeri, Francesca Campanelli, Giovanni Volpato, Laura Carboni, Giuseppe Ciliberti, Giulia Emily Stronati, Alessandro Barbarossa, Valentina La Piscopia, Barbara Bondavalli, Federico Guerra, Andrea Natale, Michela Casella

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2024

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Abstract

Background

The clinical performance of high-power, short-duration (HPSD) pulmonary vein isolation (PVI) with the novel flexible tip TactiFlex™ (TFSE) catheter, as compared to standard-power, long-duration (SPLD) PVI using the TactiCath™ (TCSE) catheter among patients undergoing catheter ablation (CA) of atrial fibrillation (AF) is currently unknown.

Methods

We conducted a prospective, observational, single-centre study including 40 consecutive patients undergoing PVI for paroxysmal/persistent AF, using HPSD ablation with the novel TFSE catheter (HPSD/TFSE group). Based on propensity score-matching, forty patients undergoing SPLD PVI with the TCSE catheter were identified (SPLD/TCSE group). In the HPSD/TFSE group, RF lesions were performed by delivering 40–50 W for 10–20 s, while in the SPLD/TCSE group, RF power was 30–35 W, targeting a lesion size index (LSI) of 4.0–5.5. The co-primary study outcomes were time required to complete PVI and first pass isolation (FPI).

Results

PVI was achieved in 100% of patients in both groups, and no major adverse events were observed. Remarkably, PVI time was shorter in the HPSD/TFSE, compared to the SPLD/TCSE group(9 [7–9] min vs. 50 [37–54] min; p < 0.001), while FPI rate was non-significantly higher in the former group(91% [146/160] vs 83% [134/160]; p = 0.063). Shorter procedural (108 [91–120] min vs. 173 [139–187] min, p < 0.001), total RF (9 [7–11] min vs. 43 [32–53] min, p < 0.001), fluoroscopy times(15 [10–19] min vs. 18 [13–26] min, p = 0.014), and lower DAP (1461 [860–2181] vs. 7200 [3400–20,800], p < 0.001) were recorded in the HPSD/TFSE group. A higher average impedance drop was obtained with HPSD/TFSE CA(17[17–18]Ω vs. 16 [15–17] Ω, p < 0.001).

Conclusions

In our initial clinical experience, HPSD PVI with the TFSE catheter proved faster than SPLD PVI with the TCSE catheter, at least equally effective in terms of FPI, and it was associated with greater impedance drop.

Graphical abstract

Main study findings. Abbreviations: DAP, dose area product; HPSD–TFSE, high-power short-duration with the TactiFlex™, Sensor Enabled™ catheter; PVI, pulmonary vein isolation; RF, radiofrequency energy; SPLD–TCSE, standard-power long-duration ablation with the TactiCath, Sensor Enabled™ catheter

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Titel: High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force–sensing catheters
verfasst von: Antonio Dello Russo
Leonardo D’Angelo
Paolo Compagnucci
Laura Cipolletta
Quintino Parisi
Yari Valeri
Francesca Campanelli
Giovanni Volpato
Laura Carboni
Giuseppe Ciliberti
Giulia Emily Stronati
Alessandro Barbarossa
Valentina La Piscopia
Barbara Bondavalli
Federico Guerra
Andrea Natale
Michela Casella
Publikationsdatum: 16.08.2023
Verlag: Springer US
Erschienen in: Journal of Interventional Cardiac Electrophysiology / Ausgabe 3/2024
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-023-01612-x

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Springer Medizin

High-power short-duration catheter ablation of atrial fibrillation: is it really a new era? Comparison between new and old radiofrequency contact force–sensing catheters

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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Springer Medizin

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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