Comparison of high-power short-duration (HPSD) ablation of atrial fibrillation using a contact force-sensing catheter and conventional technique: Initial results.

INTRODUCTION: Atrial fibrillation (AFib) ablation is alternative treatment to drugs. Literature suggests that use of contact force (CF) catheter with higher power for short periods is effective and safe.

METHODS/RESULTS: Retrospectively analyzed 76 patients undergoing the first ablation. Third five patients-group A: 27 (77%) paroxysmal AFib (PAFib) and 8 (23%) persistent AFib (PersAFib) who underwent ablation at the power of 30 W-17 mL/minute flow with a CF of 10-30 g for 30 seconds. Fourty one patients-group B: 28 (68.3%) PAFib and 13 (31.70%) PersAFib underwent ablation using 45 W on posterior wall with CF of 8/15 g, as well as 50-W anterior wall with CF of 10/20 g-35 mL/minute flow for 6 seconds. Pulmonary vein isolation in both groups and ablated. For patients not in the sinus, we performed cardioversion before ablation. No complications. Group A: Left atrial time 110 ± 29 minutes, total 148 ± 33.6 minutes, radiofrequency time (RF) 4558 ± 1998 seconds, X-ray 8.5 ± 3.5 minutes, and elevation of esophageal temperature (ET) in 26 (74.3%). group B: Left atrial time 70.7 ± 18.5 minutes ( P < .00001), total 106 ± 23 minutes ( P < .00001), RF 1909 ± 675.8 seconds ( P < .00001), X-ray 8.8 ± 6.6 minutes ( P = .221) and elevation of ET in 21 (51.20% - P = .0578). In 6 and 12 months follow-up, we had 9 (25.71%) and 11 (31.42%) recurrences in group A and 5 (12.19%) and 7 (17.07%) in group B ( P = .231 at 6 and P = .14 at 12 months), respectively.

CONCLUSIONS: HPSD was safe, useful, and efficient compared with CT, and reduced procedural time and total RF time. HPSD may reduce esophageal injury because of lower heating rate and it may reduce the recurrence of atrial tachyarrythmias.