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High-power short-duration radiofrequency ablation of typical atrial flutter

BACKGROUND: High-power short-duration (HPSD) ablation has been explored for pulmonary vein isolation. Early data suggest similar efficacy with shorter procedure times and perhaps greater safety. Data are lacking on the use of this ablation strategy for other arrhythmias. OBJECTIVE: The purpose of th...

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Autores principales: Golian, Mehrdad, Ramirez, F. Daniel, Alqarawi, Wael, Hansom, Simon P., Nery, Pablo B., Redpath, Calum J., Nair, Girish M., Shaw, George C., Davis, Darryl R., Birnie, David H., Sadek, Mouhannad M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183899/
https://www.ncbi.nlm.nih.gov/pubmed/34113888
http://dx.doi.org/10.1016/j.hroo.2020.09.002
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author Golian, Mehrdad
Ramirez, F. Daniel
Alqarawi, Wael
Hansom, Simon P.
Nery, Pablo B.
Redpath, Calum J.
Nair, Girish M.
Shaw, George C.
Davis, Darryl R.
Birnie, David H.
Sadek, Mouhannad M.
author_facet Golian, Mehrdad
Ramirez, F. Daniel
Alqarawi, Wael
Hansom, Simon P.
Nery, Pablo B.
Redpath, Calum J.
Nair, Girish M.
Shaw, George C.
Davis, Darryl R.
Birnie, David H.
Sadek, Mouhannad M.
author_sort Golian, Mehrdad
collection PubMed
description BACKGROUND: High-power short-duration (HPSD) ablation has been explored for pulmonary vein isolation. Early data suggest similar efficacy with shorter procedure times and perhaps greater safety. Data are lacking on the use of this ablation strategy for other arrhythmias. OBJECTIVE: The purpose of this study was to evaluate the safety, efficacy, and clinical outcomes of HPSD ablation in patients with typical atrial flutter compared to those undergoing ablation with conventional settings. METHODS: Consecutive patients undergoing cavotricuspid isthmus (CTI) ablation using standard power settings were compared to those performed after transitioning to HPSD ablation. Demographics, procedural details, and ablation outcomes were prospectively collected. The primary endpoint was duration of radiofrequency energy delivery. Secondary endpoints were radiation duration and analgesia requirements. RESULTS: A total of 114 consecutive subjects undergoing CTI ablation (57 standard power, 57 HPSD) were included. HPSD ablation and electroanatomic mapping/contact force (EAM/CF) use were associated with 66% (95% confidence interval [CI] 58%–73%) and 50% (95% CI 37%–60%) shorter ablation times compared to standard power and not using EAM/CF, respectively. Patients in the HPSD group required 50 mcg less fentanyl relative to the standard ablation arm after adjusting for sex, age, and comorbidities (P = .048). At a median follow-up of 6 months, 4 patients (7%) in the standard arm had recurrence of atrial flutter, compared to none in HPSD group (P = .057). CONCLUSION: HPSD is a safe and effective approach to CTI ablation. This strategy may reduce ablation time and analgesia requirements. Larger studies and longer follow-up are needed to further evaluate this strategy.
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spelling pubmed-81838992021-06-09 High-power short-duration radiofrequency ablation of typical atrial flutter Golian, Mehrdad Ramirez, F. Daniel Alqarawi, Wael Hansom, Simon P. Nery, Pablo B. Redpath, Calum J. Nair, Girish M. Shaw, George C. Davis, Darryl R. Birnie, David H. Sadek, Mouhannad M. Heart Rhythm O2 Clinical BACKGROUND: High-power short-duration (HPSD) ablation has been explored for pulmonary vein isolation. Early data suggest similar efficacy with shorter procedure times and perhaps greater safety. Data are lacking on the use of this ablation strategy for other arrhythmias. OBJECTIVE: The purpose of this study was to evaluate the safety, efficacy, and clinical outcomes of HPSD ablation in patients with typical atrial flutter compared to those undergoing ablation with conventional settings. METHODS: Consecutive patients undergoing cavotricuspid isthmus (CTI) ablation using standard power settings were compared to those performed after transitioning to HPSD ablation. Demographics, procedural details, and ablation outcomes were prospectively collected. The primary endpoint was duration of radiofrequency energy delivery. Secondary endpoints were radiation duration and analgesia requirements. RESULTS: A total of 114 consecutive subjects undergoing CTI ablation (57 standard power, 57 HPSD) were included. HPSD ablation and electroanatomic mapping/contact force (EAM/CF) use were associated with 66% (95% confidence interval [CI] 58%–73%) and 50% (95% CI 37%–60%) shorter ablation times compared to standard power and not using EAM/CF, respectively. Patients in the HPSD group required 50 mcg less fentanyl relative to the standard ablation arm after adjusting for sex, age, and comorbidities (P = .048). At a median follow-up of 6 months, 4 patients (7%) in the standard arm had recurrence of atrial flutter, compared to none in HPSD group (P = .057). CONCLUSION: HPSD is a safe and effective approach to CTI ablation. This strategy may reduce ablation time and analgesia requirements. Larger studies and longer follow-up are needed to further evaluate this strategy. Elsevier 2020-10-03 /pmc/articles/PMC8183899/ /pubmed/34113888 http://dx.doi.org/10.1016/j.hroo.2020.09.002 Text en © 2020 Heart Rhythm Society. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical
Golian, Mehrdad
Ramirez, F. Daniel
Alqarawi, Wael
Hansom, Simon P.
Nery, Pablo B.
Redpath, Calum J.
Nair, Girish M.
Shaw, George C.
Davis, Darryl R.
Birnie, David H.
Sadek, Mouhannad M.
High-power short-duration radiofrequency ablation of typical atrial flutter
title High-power short-duration radiofrequency ablation of typical atrial flutter
title_full High-power short-duration radiofrequency ablation of typical atrial flutter
title_fullStr High-power short-duration radiofrequency ablation of typical atrial flutter
title_full_unstemmed High-power short-duration radiofrequency ablation of typical atrial flutter
title_short High-power short-duration radiofrequency ablation of typical atrial flutter
title_sort high-power short-duration radiofrequency ablation of typical atrial flutter
topic Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183899/
https://www.ncbi.nlm.nih.gov/pubmed/34113888
http://dx.doi.org/10.1016/j.hroo.2020.09.002
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