Optimized workflow for paroxysmal atrial fibrillation ablation using very high power short duration

Area of Science:

• Cardiology
• Electrophysiology
• Medical Technology

Background:

• Pulmonary vein isolation (PVI) is a key treatment for paroxysmal atrial fibrillation (PAF).
• Traditional PVI procedures can be time-consuming.
• Optimizing PVI protocols is crucial for improving patient outcomes and healthcare efficiency.

Purpose of the Study:

• To evaluate a standardized PVI protocol using advanced tools.
• To assess the impact of this protocol on procedure duration, efficacy, and safety.
• To determine if this workflow reduces treatment times for PAF patients.

Main Methods:

• Prospective enrollment of 138 consecutive PAF patients undergoing PVI.
• Utilization of a bidirectional steerable sheath, high-density mapping, and very high-power-short-duration (vHPSD) ablation catheters.
• Systematic collection and analysis of procedural and electrophysiology (EP) laboratory times, with 12 and 24-month follow-up for arrhythmia recurrence.

Main Results:

• Successful PVI was achieved in 100% of patients.
• First-pass isolation (PFI) success rate was 93% with a mean left atrial (LA) dwell time of 32 minutes.
• Mean skin-to-skin time was 58 minutes, and total EP lab time was 85 minutes, with a 3% complication rate.

Conclusions:

• The standardized workflow significantly reduces procedural times for PVI.
• This approach demonstrates high efficacy, with low arrhythmia recurrence rates at 12 and 24 months.
• The protocol is safe and effective for treating PAF without compromising patient safety.