Initial Results of Routine Use of Atrial Fibrillation Ablation with High Power Short Duration Technique

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Fabricio Vassallo, Lucas Luis Meigre, Eduardo Serpa, Carlos Lovatto, Christiano Cunha, Hermes Carloni, Aloyr Simoes Jr., Karla Meira, Flavia Pezzin, Orly Lacerda Jr., Walter Batista Jr., Alberto Nogueira Jr., Dalton Amaral, Dalbian Gasparini

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Published: 18 January 2021 | Article Type :

Abstract

Introduction: Different results are described after atrial fibrillation (AF) ablation and multiples predictors of recurrence are well established. Objective: Evaluate and analyze the benefits of first atrial fibrillation (AF) ablation with high-power short-duration (HPSD).

Methods: Observational, retrospective study, 212 patients submitted to High Power Short Duration AF ablation (HPSD). Ablation in left atrial posterior wall was performed with 45W with contact force of 3 to 10 grams during 4 to 6 seconds, in the anterior wall we used 50W with contact force of 5 to 20 grams during 4 to 6 seconds and a pump flow of 35ml/min. Males were 155 (73.11%), mean age 61.73 years, paroxysmal AF in 132 (62.26%), 126 (59.43%) hypertension, 96 (45.28%) obstructive apnea, 65(30.66%) arterial disease, 41(19.34%) Diabetes, and 16(7.55%) strokes. Mean time from AF diagnosis to ablation was 20.43 months CHADS2VASC2 2.51.

Results: Mean left atrial time was 72.83 minutes, mean total procedure time 94.79 minutes, mean radiofrequency time of 1,723.8 seconds, 76 (35.85%) of esophageal temperature elevation, mean Xray time of 7.58 minutes, bilateral first-pass isolation effect in 168 (79.25%) patients and mean follow-up was 22.12 (4 to 36) months and recurrence rate after blanking period occurred in 33 (15.57%) patients. Complications were local hematomas in 62 (29.25%) patients, 2 (0.94%) femoral artery pseudoaneurysm, 2 (0.94%) pericardial effusions and 1 (0.47%) cardiac tamponade occurred after transeptal puncture.

Conclution: HPSD showed a high rate of sinus rhythm during the follow-up. Also, we demonstrated a low rate of esophageal heating, a high rate of first-pass isolation effect and short left atrial, total ablation and radiofrequency times with HPSD technique.

Keywords: atrial fibrillation, esophageal temperature, recurrence rate, first-pass isolation, and atrial fibrillation ablation.

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Fabricio Vassallo, Lucas Luis Meigre, Eduardo Serpa, Carlos Lovatto, Christiano Cunha, Hermes Carloni, Aloyr Simoes Jr., Karla Meira, Flavia Pezzin, Orly Lacerda Jr., Walter Batista Jr., Alberto Nogueira Jr., Dalton Amaral, Dalbian Gasparini. (2021-01-18). "Initial Results of Routine Use of Atrial Fibrillation Ablation with High Power Short Duration Technique." *Volume 4*, 1, 6-13