scholarly journals High‐power short duration and low‐power long duration in atrial fibrillation ablation: A meta‐analysis

2020 ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chol Techorueangwiwat ◽  
Chanavuth Kanitsoraphan ◽  
Thiratest Leesutipornchai ◽  
Nazem Akoum ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Low Power ◽  
Short Duration ◽  
High Power ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Long Duration

scholarly journals High Power Short Duration and Low Power Long Duration in Atrial Fibrillation Ablation: A Meta-Analysis

2020 ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chol Techorueangwiwat ◽  
Chanavuth Kanitsoraphan ◽  
Thiratest Leesutipornchai ◽  
Nazem Akoum ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Low Power ◽  
Short Duration ◽  
High Power ◽  
Meta Analysis ◽  
Atrial Fibrillation Ablation ◽  
Long Duration

scholarly journals The First-Pass Isolation Effect in High-Power Short-Duration Compared to Low-Power Long-Duration Atrial Fibrillation Ablation: a Predictor of Success

2020 ◽  
Vol 33 (3) ◽  
pp. 161-169
Author(s):  
Fabricio Vassallo ◽  
Lucas Luis Meigre ◽  
Eduardo Serpa ◽  
Carlos Lovatto ◽  
Christiano Cunha ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Low Power ◽  
Short Duration ◽  
High Power ◽  
Arterial Disease ◽  
Obstructive Apnea ◽  
Long Duration ◽  
First Pass

Introduction: Different results are described after atrial fibrillation ablation and multiples predictors of recurrence are well established. Objective: Evaluate and analyze if first-pass isolation effect (FPI) during first atrial fibrillation (AF) ablation with high-power short-duration (HPSD) comparing to low-power long-duration (LPLD) can impact on late outcome. Methods: Observational, retrospective study, 144 patients submitted to HPSD and LPLD ablation. HPSD: 71 patients, 50 (70.42%) males, mean age 59.73 years, 52 (73.24%) hypertension, 44 (61.97%) obstructive apnea, 23 (32.39%) arterial disease, 20 (28.17%) diabetes, and 10(14.08%) stroke. CHADS2VASC2 2.57. CT: 73 patients, 50 (68.49%) males, mean age 60.7 years, 53 (72.60%) hypertension, 41 (56.16%) obstructive apnea, 28 (38.36%) arterial disease, 14 (19.17%) diabetes and 8 (10.96%) stroke. CHAD2SVASC2 2.22. Results: Recurrence occurred in 33 patients (22.92%) at 12 months follow-up, HPSD with 9 patients and LPLD with 24 patients. Higher rate of bilateral FPI were observed in HPSD patients with 62 of 71 patients comparing to 17 of 73 patients in LPLD (P < 0.00001). At the end of study 62 (87.32%) of 71 HPSD patients were in sinus rhythm comparing to 49 (67.12%) of 73 patients in LPLD (P 0.0039). Conclusion: HPSD ablation produced higher rates of FPI comparing to LPLD. HPSD compared to LPLD showed a superiority in maintaining sinus rhythm at 12 months. At patients submitted to HPSD protocol ablation, FPI could predict higher rate of sinus rhythm at 12 months follow-up.

Abstract 12970: High Power Short Duration and Low Power Long Duration in Atrial Fibrillation Ablation: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jakrin Kewcharoen ◽  
Chol Techorueangwiwat ◽  
Chanavuth Kanitsoraphan ◽  
Thiratest Leesutipornchai ◽  
Wasawat Vutthikraivit ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Low Power ◽  
High Power ◽  
Injury Risk ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Esophageal Injury ◽  
Procedure Time ◽  
Case Control Studies ◽  
Large Populations

Background: Although high power, shorter duration (HPSD) ablation and low power, longer duration (LPLD) ablation strategies for atrial fibrillation (AF) are frequently advocated to enhance safety and efficacy, there exists a need for comparative data from large populations. We performed a meta-analysis to compare arrhythmia-free survival, procedure time and complications rates between the two strategies. Methods: We searched the databases of MEDLINE and EMBASE from inception to April 2020. Included studies were case-control studies, cohort studies, or randomized controlled trials that compared patients undergoing HPSD and LPLD strategies for AF ablation and reported either of the following outcomes: freedom from atrial tachyarrhythmia (AT) including AF and atrial flutter, procedure time, or periprocedural complications. Data from each study were combined using the random-effects model to calculate odds ratio (OR) and weighted mean difference (WMD) with 95% confidence interval (CI). Results: Ten studies from 2006 to 2020 involving 2,189 patients were included (1,350 patients underwent HPSD strategy and 839 patients underwent LPLD strategy). Both HPSD and LPLD strategies resulted in a similar freedom from AT at 12-month follow-up (OR=1.36, 95% CI:0.91-2.04, p=0.13, Figure 1A). HPSD strategy did result in a significant reduction in total procedure time (WMD=47.34, 95% CI:29.47-65.21, p<0.001, Figure 1B) compared to LPSD. HPSD wasn’t associated with reduction in esophageal ulcer/arterioesophageal fistula (OR=0.35, 95%CI=0.12-1.06, p=0.06) or pericardial effusion/cardiac tamponade (OR=0.96, 95%CI: 0.24-3.79, p=0.95) Conclusions: In this large meta-analysis both LPLD and HPSD are equally effective and safe. Although HPSD is often advocated to reduce esophageal injury, risk was similar between approaches. However, HPSD strategy significantly lowers procedure times.

High-Power Short-Duration Atrial Fibrillation Ablation: Strategy to Reduce Luminal Esophageal Temperature With Contact Force Catheters

2021 ◽  
Author(s):  
Fabricio Sarmento Vassallo ◽  
Lucas Luis Meigre ◽  
Eduardo Giestas Serpa ◽  
Christiano Lemos da Cunha ◽  
Aloyr Gonçalves Simões Jr. ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Short Duration ◽  
Contact Force ◽  
High Power ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Temperature
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