Arrhythmias & electrophysiology

Atrial fibrillation ablation workflow optimization facilitated by high-power short-duration ablation and high-resolution mapping

EuropacePublished Comparative cohort study

Authors' conclusion

The integration of high-density mapping and HPSD protocols into an institutional AF ablation process resulted in reduced procedure times without compromising safety or efficacy.

Study context

Population
Patients undergoing pulmonary vein isolation (PVI) for AF without additional left atrial ablation
Participants
307 patients
Exposure
High-power short-duration (HPSD) ablation with high-density mapping (50 W ablation index (AI); 90 W/4 s) vs circular catheter mapping with 30/35 W AI
  • 30/35 W AIn = 102reference
  • 50 W AIn = 102
  • 90 W/4 sn = 103
Outcome
Procedural times
Methodological detailsthree standardized electrophysiology (EP) laboratory set-ups
  • Three standardized EP laboratory set-ups

Main finding

As reported in the abstract

GroupSkin-to-skin timeTotal laboratory time
30/35 W AI105.3 ± 22.7132.8 ± 42.1
50 W AI81.4 ± 21.3107.4 ± 25.7
90 W/4 s69.5 ± 12.295.2 ± 14.0

Skin-to-skin time

30/35 W AI105.3 ± 22.7
50 W AI81.4 ± 21.3
90 W/4 s69.5 ± 12.2

Total laboratory time

30/35 W AI132.8 ± 42.1
50 W AI107.4 ± 25.7
90 W/4 s95.2 ± 14.0
  • 30/35 W AI vs 50 W AI vs 90 W/4 s: P ≤ 0.001 — skin-to-skin time
  • 30/35 W AI vs 50 W AI vs 90 W/4 s: P < 0.001 — total laboratory time

Observational data: associations, not effects.

Further findings

Arrhythmia-free survival · 12 months

Not different among the study groups
log-rank P = 0.96

Original publication

Atrial fibrillation ablation workflow optimization facilitated by high-power short-duration ablation and high-resolution mapping. Europace. Published 22 March 2024. doi:10.1093/europace/euae067

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