Arrhythmias & electrophysiologyCohort study
Redo Ablation Following Lesion Size Index (LSI) Algorithm–Guided High-Power Short-Duration vs LSI Algorithm–Guided Conventional Radiofrequency for Atrial Fibrillation
- retrospective analysis
- consecutive patients
Authors' conclusion
LSI algorithm-guided PV isolation using HPSD ablation at 50 W is associated with lower rates of redo procedures and PV reconnection compared with 30 W ablation at the same LSI algorithm target, suggesting greater durability. The higher reconnection rate observed in the ridge/Marshall region likely reflects insufficient lesion depth of HPSD RF in thicker atrial tissue.
Study context
- Population
- Patients undergoing redo procedures after a first pulmonary vein (PV) isolation with LSI algorithm-guided radiofrequency for atrial fibrillationconsecutive patients with a first PV isolation, 93 underwent a redo procedure · conventional (30 W) 362 · high-power, short-duration (HPSD) (50 W) 339
- Participants
- 701 patients
- Exposure
- Lesion Size Index (LSI) algorithm-guided radiofrequency with HPSD or conventional radiofrequency
Main finding
As reported in the abstract
Redo procedure
conventional
71
events
HPSD
22
events
- Total patients with a redo procedure
- 93
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| Redo procedure · first year postablation | conventional 5% · HPSD 1.5% | P = 0.009 |
| Redo procedure · second year | conventional 5% · HPSD 1.8% | P = 0.020 |
| Proportion of isolated PVs (per-vein analysis) · higher in the HPSD group | HPSD 32% · conventional 18% | P = 0.048 |
| Reconnection of the right inferior PV (per-vein analysis) · lower in the HPSD group | HPSD 25% · conventional 62% | P = 0.021 |
| Gaps in the ridge and Marshall epicardial connections (per-vein analysis) · more frequent in the HPSD group | HPSD 50% · conventional 22% | P = 0.012 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Redo Ablation Following LSI Algorithm–Guided High-Power Short-Duration vs LSI Algorithm–Guided Conventional Radiofrequency for Atrial Fibrillation. JACC Clin Electrophysiol. Published 11 June 2026. doi:10.1016/j.jacep.2026.04.029
Summarised from the published abstract; every number is checked against it