BMC Cardiovascular Disorders (Aug 2021)

Comparison of lesion characteristics between conventional and high-power short-duration ablation using contact force-sensing catheter in patients with paroxysmal atrial fibrillation

  • Chun-Chao Chen,
  • Po-Tseng Lee,
  • Vu Van Ba,
  • Chieh-Mao Chuang,
  • Yenn-Jiang Lin,
  • Li-Wei Lo,
  • Yu-Feng Hu,
  • Fa-Po Chung,
  • Chin-Yu Lin,
  • Ting-Yung Chang,
  • Jennifer Jeanne Vicera,
  • Ting-Chun Huang,
  • Chih-Min Liu,
  • Cheng-I Wu,
  • Isaiah C. Lugtu,
  • Ankit Jain,
  • Shih-Lin Chang,
  • Shih-Ann Chen

DOI
https://doi.org/10.1186/s12872-021-02196-y
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 9

Abstract

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Abstract Background Transmural lesion creation is essential for effective atrial fibrillation (AF) ablation. Lesion characteristics between conventional energy and high-power short-duration (HPSD) setting in contact force-guided (CF) ablation for AF remained unclear. Methods Eighty consecutive AF patients who received CF with conventional energy setting (power control: 25–30 W, force–time integral = 400 g s, n = 40) or with HPSD (power control: 40–50 W, 10 s, n = 40) ablation were analyzed. Of them, 15 patients in each conventional and HPSD group were matched by age and gender respectively for ablation lesions analysis. Type A and B lesions were defined as a lesion with and without significant voltage reduction after ablation, respectively. The anatomical distribution of these lesions and ablation outcomes among the 2 groups were analyzed. Results 1615 and 1724 ablation lesions were analyzed in the conventional and HPSD groups, respectively. HPSD group had a higher proportion of type A lesion compared to conventional group (P < 0.01). In the conventional group, most type A lesions were at the right pulmonary vein (RPV) posterior wall (50.2%) whereas in the HPSD group, most type A lesions were at the RPV anterior wall (44.0%) (P = 0.04). The procedure time and ablation time were significantly shorter in the HPSD group than that in the conventional group (91.0 ± 12.1 vs. 124 ± 14.2 min, P = 0.03; 30.7 ± 19.2 vs. 57.8 ± 21 min, P = 0.02, respectively). At a mean follow-up period of 11 ± 1.4 months, there were 13 and 7 patients with recurrence in conventional and HPSD group respectively (P = 0.03). Conclusion Optimal ablation lesion characteristics and distribution after conventional and HPSD ablation differed significantly. HPSD ablation had shorter ablation time and lower recurrence rate than did conventional ablation.

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