One-year outcomes in patients undergoing very high-power short-duration temperature-controlled ablation for atrial fibrillation

Abstract Funding Acknowledgements Type of funding sources: None. Background The very high-power short-duration (vHPSD) temperature-controlled ablation (vHPSD) improves the efficiency of pulmonary vein isolation (PVI) procedures. Aims We evaluated the procedural and 12-months outcomes in atrial fibrillation (AF) patients undergoing PVI by means of vHPSD ablation. In patients with AF or atrial tachy-arrythmia (AT) recurrence undergoing a redo procedure the durability of the PVI was investigated. Methods Consecutive paroxysmal/persistent AF patients undergoing PVI with the vHPSD ablation strategy (90 W, for 4 s) were enrolled. The rate of PVI, first pass isolation, acute reconnection, and procedural complications were evaluated. Follow-up examinations and EKG were scheduled at 1,6, and 12 months. In case of AF/AT recurrence, patients underwent a redo procedure. Results Overall, 163 AF patients (29 persistent and 134 paroxysmal) were enrolled. The PVI was reached in 100% of patients (88% at first pass). The rate of acute reconnection was 2%. The radiofrequency, fluoroscopy and procedural times were respectively 5,5±1 min, 9±1 min and 75±20 min. No death, tamponade nor steam pops occurred, however 5 patients had vascular complications. The 12-months freedom from AF/AT recurrence was 84% in paroxysmal patients and 71% in persistent. Overall, 9 patients underwent a redo procedure, and in 4 all veins were still isolated, whereas in 5 pulmonary vein reconnections were found. The PVI durability was 83%. No overt complications were observed in the follow-up. Conclusions The vHPSD ablation represents an effective and safe ablation strategy to achieve PVI. The 12-months follow-up showed high freedom from AF/AT recurrence and a good safety profile.