High Power Short Duration Atrial Fibrillation Ablation: Long-Term Predictors of Success and Recurrence - A...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• High-power short-duration (HPSD) ablation is a common technique for atrial fibrillation (AF).
• Limited data exists on the efficacy and predictors of success when using HPSD in conjunction with the dragging technique (DT).

Purpose of the Study:

• To conduct a multivariate analysis identifying clinical and procedural predictors of success and recurrence in AF patients undergoing HPSD with DT ablation.

Main Methods:

• Prospective enrollment of 214 patients undergoing their first AF ablation in sinus rhythm.
• Application of DT with 50W radiofrequency power, 10-20g contact force (CF) on anterior walls, and 5-10g CF on posterior walls at 40 mL/min flow rate.
• Statistical significance determined by p < 0.05.

Main Results:

• Recurrence predictors included age ≥ 65 years, obesity (BMI > 30), CHA2DS2VASC score ≥ 3, persistent AF (PersAF), and a heart rate increase < 10% post-ablation.
• Success predictors were a heart rate increase ≥ 30% and left atrium time (LAT) < 60 minutes.
• Overall AF recurrence after 90 days was 20.1%.

Conclusions:

• Clinical predictors for AF recurrence with HPSD and DT include older age, obesity, high CHA2DS2VASC score, and persistent AF.
• Procedural predictors for recurrence involve a heart rate increase < 10% post-ablation.
• Successful ablation is associated with a heart rate increase ≥ 30% and shorter left atrium time (< 60 min).