Direct comparison of two 50 W high power short duration approaches—Temperature‐ versus ablation index‐guided radiofrequency ablation for atrial fibrillation
Introduction Approaches applying higher energy levels for shorter periods (high power short duration, HPSD) to improve lesion formation for atrial fibrillation (AF) ablation have been introduced. This single‐center study aimed to compare the efficacy, safety, and lesion formation using the novel Dia...
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2022-12, Vol.33 (12), p.2517-2527 |
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| container_title | Journal of cardiovascular electrophysiology |
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| creator | Guckel, Denise Bergau, Leonard Braun, Martin El Hamriti, Mustapha Mörsdorf, Maximilian Fink, Thomas Sciacca, Vanessa Khalaph, Moneeb Imnadze, Guram Sommer, Philipp Sohns, Christian |
| description | Introduction
Approaches applying higher energy levels for shorter periods (high power short duration, HPSD) to improve lesion formation for atrial fibrillation (AF) ablation have been introduced. This single‐center study aimed to compare the efficacy, safety, and lesion formation using the novel DiamondTemp (DT) catheter or an ablation index (AI)‐guided HPSD ablation protocol using a force‐sensing catheter with surround‐flow irrigation.
Methods
One hundred thirteen consecutive patients undergoing radiofrequency‐guided catheter ablation (RFCA) for AF were included. Forty‐five patients treated with the DT catheter (50 W, 9 s), were compared to 68 consecutive patients undergoing AI‐guided ablation (AI anterior 550; AI posterior 400) adherent to a 50 W HPSD protocol. Procedural data and AF recurrence were evaluated.
Results
Acute procedural success was achieved in all patients (n = 113, 100%). DT‐guided AF ablation was associated with a longer mean procedure duration (99.10 ± 28.30 min vs. 78.24 ± 25.55, p |
| doi_str_mv | 10.1111/jce.15674 |
| format | Article |
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Approaches applying higher energy levels for shorter periods (high power short duration, HPSD) to improve lesion formation for atrial fibrillation (AF) ablation have been introduced. This single‐center study aimed to compare the efficacy, safety, and lesion formation using the novel DiamondTemp (DT) catheter or an ablation index (AI)‐guided HPSD ablation protocol using a force‐sensing catheter with surround‐flow irrigation.
Methods
One hundred thirteen consecutive patients undergoing radiofrequency‐guided catheter ablation (RFCA) for AF were included. Forty‐five patients treated with the DT catheter (50 W, 9 s), were compared to 68 consecutive patients undergoing AI‐guided ablation (AI anterior 550; AI posterior 400) adherent to a 50 W HPSD protocol. Procedural data and AF recurrence were evaluated.
Results
Acute procedural success was achieved in all patients (n = 113, 100%). DT‐guided AF ablation was associated with a longer mean procedure duration (99.10 ± 28.30 min vs. 78.24 ± 25.55, p < .001) and more RF applications (75.24 ± 30.76 min vs. 61.27 ± 14.06, p = .019). RF duration (792.13 ± 311.23 s vs. 1035.54 ± 287.24 s, p < .001) and fluoroscopy dose (183.81 ± 178.13 vs. 295.80 ± 247.54 yGym2, p = .013) were lower in the DT group. AI‐guided HPSD was associated with a higher AF‐free survival rate without reaching statistical significance (p = .088). Especially patients with PERS AF (p = .009) as well as patients with additional atrial arrhythmia substrate (p = .002) benefited from an AI‐guided ablation strategy.
Conclusion
Temperature‐ and AI‐ controlled HPSD RFCA using 50 W was safe and effective. AI‐guided HPSD ablation seems to be associated with shorter procedure durations and fewer RF applications. Particularly in advanced AF, freedom from AF‐recurrence may be improved using an AI‐guided HPSD approach.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.15674</identifier><identifier>PMID: 36104929</identifier><language>eng</language><publisher>United States</publisher><subject>50 W ; atrial fibrillation ; DiamondTemp ; high power short duration ; novel technologies ; radiofrequency ablation</subject><ispartof>Journal of cardiovascular electrophysiology, 2022-12, Vol.33 (12), p.2517-2527</ispartof><rights>2022 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2904-6b19fed42dc50d83d7b6dae990600608b43c45562faeebe38b2883d624954c123</citedby><cites>FETCH-LOGICAL-c2904-6b19fed42dc50d83d7b6dae990600608b43c45562faeebe38b2883d624954c123</cites><orcidid>0000-0003-1470-7157 ; 0000-0002-3037-8704 ; 0000-0003-0490-5862</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjce.15674$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjce.15674$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36104929$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guckel, Denise</creatorcontrib><creatorcontrib>Bergau, Leonard</creatorcontrib><creatorcontrib>Braun, Martin</creatorcontrib><creatorcontrib>El Hamriti, Mustapha</creatorcontrib><creatorcontrib>Mörsdorf, Maximilian</creatorcontrib><creatorcontrib>Fink, Thomas</creatorcontrib><creatorcontrib>Sciacca, Vanessa</creatorcontrib><creatorcontrib>Khalaph, Moneeb</creatorcontrib><creatorcontrib>Imnadze, Guram</creatorcontrib><creatorcontrib>Sommer, Philipp</creatorcontrib><creatorcontrib>Sohns, Christian</creatorcontrib><title>Direct comparison of two 50 W high power short duration approaches—Temperature‐ versus ablation index‐guided radiofrequency ablation for atrial fibrillation</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Introduction
Approaches applying higher energy levels for shorter periods (high power short duration, HPSD) to improve lesion formation for atrial fibrillation (AF) ablation have been introduced. This single‐center study aimed to compare the efficacy, safety, and lesion formation using the novel DiamondTemp (DT) catheter or an ablation index (AI)‐guided HPSD ablation protocol using a force‐sensing catheter with surround‐flow irrigation.
Methods
One hundred thirteen consecutive patients undergoing radiofrequency‐guided catheter ablation (RFCA) for AF were included. Forty‐five patients treated with the DT catheter (50 W, 9 s), were compared to 68 consecutive patients undergoing AI‐guided ablation (AI anterior 550; AI posterior 400) adherent to a 50 W HPSD protocol. Procedural data and AF recurrence were evaluated.
Results
Acute procedural success was achieved in all patients (n = 113, 100%). DT‐guided AF ablation was associated with a longer mean procedure duration (99.10 ± 28.30 min vs. 78.24 ± 25.55, p < .001) and more RF applications (75.24 ± 30.76 min vs. 61.27 ± 14.06, p = .019). RF duration (792.13 ± 311.23 s vs. 1035.54 ± 287.24 s, p < .001) and fluoroscopy dose (183.81 ± 178.13 vs. 295.80 ± 247.54 yGym2, p = .013) were lower in the DT group. AI‐guided HPSD was associated with a higher AF‐free survival rate without reaching statistical significance (p = .088). Especially patients with PERS AF (p = .009) as well as patients with additional atrial arrhythmia substrate (p = .002) benefited from an AI‐guided ablation strategy.
Conclusion
Temperature‐ and AI‐ controlled HPSD RFCA using 50 W was safe and effective. AI‐guided HPSD ablation seems to be associated with shorter procedure durations and fewer RF applications. Particularly in advanced AF, freedom from AF‐recurrence may be improved using an AI‐guided HPSD approach.</description><subject>50 W</subject><subject>atrial fibrillation</subject><subject>DiamondTemp</subject><subject>high power short duration</subject><subject>novel technologies</subject><subject>radiofrequency ablation</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kcFO3DAURa2qqFBg0R-ovGwXATuxnWRZDbSAkNhQsYwc-4UxSsbpc8Iwu9l210U_oBt-hE-ZL8EQ2q6wLPnJ9-jqPl1CPnB2wOM5vDFwwKXKxRuyw6VgScFV_jbOTMgkK_Jsm7wP4YYxnikm35HtTEWpTMsdcn_kEMxAje96jS74BfUNHZaeSrZZ_7x6-DN313Pa-yUgDXOPA7Uj6sFFUPc9em3mEDbr35fQ9RCFEWGz_kVvAcMYqK7biXULC3dRuB6dBUtRW-cbhB8jLMzqP9Z4pHpAp1vauBpdO_3vka1GtwH2X95d8v3r8eXsJDm_-HY6-3KemLRkIlE1LxuwIrVGMltkNq-V1VCWTLF4i1pkRkip0kYD1JAVdVpESqWilMLwNNslnybfuFiMFoaqc8FATLEAP4YqzblQUnHJI_p5Qg36EBCaqkfXaVxVnFVPrVSxleq5lch-fLEd6w7sP_JvDRE4nICla2H1ulN1NjueLB8BwEOfCQ</recordid><startdate>202212</startdate><enddate>202212</enddate><creator>Guckel, Denise</creator><creator>Bergau, Leonard</creator><creator>Braun, Martin</creator><creator>El Hamriti, Mustapha</creator><creator>Mörsdorf, Maximilian</creator><creator>Fink, Thomas</creator><creator>Sciacca, Vanessa</creator><creator>Khalaph, Moneeb</creator><creator>Imnadze, Guram</creator><creator>Sommer, Philipp</creator><creator>Sohns, Christian</creator><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1470-7157</orcidid><orcidid>https://orcid.org/0000-0002-3037-8704</orcidid><orcidid>https://orcid.org/0000-0003-0490-5862</orcidid></search><sort><creationdate>202212</creationdate><title>Direct comparison of two 50 W high power short duration approaches—Temperature‐ versus ablation index‐guided radiofrequency ablation for atrial fibrillation</title><author>Guckel, Denise ; Bergau, Leonard ; Braun, Martin ; El Hamriti, Mustapha ; Mörsdorf, Maximilian ; Fink, Thomas ; Sciacca, Vanessa ; Khalaph, Moneeb ; Imnadze, Guram ; Sommer, Philipp ; Sohns, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2904-6b19fed42dc50d83d7b6dae990600608b43c45562faeebe38b2883d624954c123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>50 W</topic><topic>atrial fibrillation</topic><topic>DiamondTemp</topic><topic>high power short duration</topic><topic>novel technologies</topic><topic>radiofrequency ablation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guckel, Denise</creatorcontrib><creatorcontrib>Bergau, Leonard</creatorcontrib><creatorcontrib>Braun, Martin</creatorcontrib><creatorcontrib>El Hamriti, Mustapha</creatorcontrib><creatorcontrib>Mörsdorf, Maximilian</creatorcontrib><creatorcontrib>Fink, Thomas</creatorcontrib><creatorcontrib>Sciacca, Vanessa</creatorcontrib><creatorcontrib>Khalaph, Moneeb</creatorcontrib><creatorcontrib>Imnadze, Guram</creatorcontrib><creatorcontrib>Sommer, Philipp</creatorcontrib><creatorcontrib>Sohns, Christian</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guckel, Denise</au><au>Bergau, Leonard</au><au>Braun, Martin</au><au>El Hamriti, Mustapha</au><au>Mörsdorf, Maximilian</au><au>Fink, Thomas</au><au>Sciacca, Vanessa</au><au>Khalaph, Moneeb</au><au>Imnadze, Guram</au><au>Sommer, Philipp</au><au>Sohns, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Direct comparison of two 50 W high power short duration approaches—Temperature‐ versus ablation index‐guided radiofrequency ablation for atrial fibrillation</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2022-12</date><risdate>2022</risdate><volume>33</volume><issue>12</issue><spage>2517</spage><epage>2527</epage><pages>2517-2527</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Introduction
Approaches applying higher energy levels for shorter periods (high power short duration, HPSD) to improve lesion formation for atrial fibrillation (AF) ablation have been introduced. This single‐center study aimed to compare the efficacy, safety, and lesion formation using the novel DiamondTemp (DT) catheter or an ablation index (AI)‐guided HPSD ablation protocol using a force‐sensing catheter with surround‐flow irrigation.
Methods
One hundred thirteen consecutive patients undergoing radiofrequency‐guided catheter ablation (RFCA) for AF were included. Forty‐five patients treated with the DT catheter (50 W, 9 s), were compared to 68 consecutive patients undergoing AI‐guided ablation (AI anterior 550; AI posterior 400) adherent to a 50 W HPSD protocol. Procedural data and AF recurrence were evaluated.
Results
Acute procedural success was achieved in all patients (n = 113, 100%). DT‐guided AF ablation was associated with a longer mean procedure duration (99.10 ± 28.30 min vs. 78.24 ± 25.55, p < .001) and more RF applications (75.24 ± 30.76 min vs. 61.27 ± 14.06, p = .019). RF duration (792.13 ± 311.23 s vs. 1035.54 ± 287.24 s, p < .001) and fluoroscopy dose (183.81 ± 178.13 vs. 295.80 ± 247.54 yGym2, p = .013) were lower in the DT group. AI‐guided HPSD was associated with a higher AF‐free survival rate without reaching statistical significance (p = .088). Especially patients with PERS AF (p = .009) as well as patients with additional atrial arrhythmia substrate (p = .002) benefited from an AI‐guided ablation strategy.
Conclusion
Temperature‐ and AI‐ controlled HPSD RFCA using 50 W was safe and effective. AI‐guided HPSD ablation seems to be associated with shorter procedure durations and fewer RF applications. Particularly in advanced AF, freedom from AF‐recurrence may be improved using an AI‐guided HPSD approach.</abstract><cop>United States</cop><pmid>36104929</pmid><doi>10.1111/jce.15674</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1470-7157</orcidid><orcidid>https://orcid.org/0000-0002-3037-8704</orcidid><orcidid>https://orcid.org/0000-0003-0490-5862</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | 50 W atrial fibrillation DiamondTemp high power short duration novel technologies radiofrequency ablation |
| title | Direct comparison of two 50 W high power short duration approaches—Temperature‐ versus ablation index‐guided radiofrequency ablation for atrial fibrillation |
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