Very high-power short-duration ablation for pulmonary vein isolation utilizing a very-close protocol-the FAST AND FURIOUS PVI study

被引:48
作者
Heeger, Christian-H [1 ,2 ]
Sano, Makoto [1 ,3 ]
Popescu, Sorin Stefan [1 ]
Subin, Behnam [1 ]
Feher, Marcel [1 ]
Phan, Huong-Lan [1 ]
Kirstein, Bettina [1 ]
Vogler, Julia [1 ]
Eitel, Charlotte [1 ]
Hatahet, Sascha [1 ]
Kuck, Karl-Heinz [1 ,4 ]
Tilz, Roland R. [1 ,2 ,4 ]
机构
[1] Univ Heart Ctr Lubeck, Univ Hosp Schleswig Holstein, Dept Rhythmol, Ratzeburger Allee 160, D-23538 Lubeck, Germany
[2] German Ctr Cardiovasc Res DZHK, Partner Site Hamburg Kiel Lubeck, Lubeck, Germany
[3] Hamamatsu Univ Hosp, Div Cardiol, Internal Med 3, 1-20-1 Handayama,Higashi Ku, Hamamatsu, Shizuoka 4313192, Japan
[4] LANS Cardio, Stephanspl 5, D-20354 Hamburg, Germany
来源
EUROPACE | 2023年 / 25卷 / 03期
关键词
Atrial fibrillation; High-power short-duration; Pulmonary vein isolation; Radiofrequency; Acute efficacy; CRYOBALLOON;
D O I
10.1093/europace/euac243
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims The very high-power short-duration (vHP-SD) radiofrequency (RF) ablation concept of atrial fibrillation (AF) treatment by pulmonary vein isolation (PVI) aims for safer, more effective, and faster procedures. Utilizing conventional ablation, the 'close protocol' has been verified. Since lesion formation of vHP-SD ablation creates wider but shallower lesions we adapted the close protocol to an individualized and tighter 'very-close protocol' of 3-4 mm of inter-lesion distance (ILD) at the anterior and 5-6 mm at the posterior aspect of the left atrium using vHP-SD only. Here, we evaluated the safety and efficacy of vHP-SD ablation for PVI utilizing a very-close protocol in comparison with standard ablation. Methods and results A total of 50 consecutive patients with symptomatic AF were treated with a very-close protocol utilizing vHP-SD (vHP-SD group). The data were compared with 50 consecutive patients treated by the ablation-index-guided strategy (control group). The mean RF time was 352 +/- 81 s (vHP-SD) and 1657 +/- 570 s (control, P < 0.0001), and the mean procedure duration was 59 +/- 13 (vHP-SD) and 101 +/- 38 (control, P < 0.0001). The first-pass isolation rate was 74% (vHP-SD) and 76% (control, P = 0.817). Severe adverse events were reported in 1 (2%, vHP-SD) and 3 (6%, control) patients (P = 0.307). A 12-month recurrence-free survival was 78% (vHP-SD) and 64% (control, P = 0.142). PVI durability assessed during redo-procedures was 75% (vHP-SD) vs. 33% (control, P < 0.001). Conclusions PVI solely utilizing vHP-SD via a very-close protocol provides safe and effective procedures with a high rate of first-pass isolations. The procedure duration and ablation time were remarkably low. A 12-month follow-up and PVI durability are promising.
引用
收藏
页码:880 / 888
页数:9
相关论文
共 20 条
[1]   High-power and short-duration ablation for pulmonary vein isolation: Safety, efficacy, and long-term durability [J].
Barkagan, Michael ;
Contreras-Valdes, Fernando M. ;
Leshem, Eran ;
Buxton, Alfred E. ;
Nakagawa, Hiroshi ;
Anter, Elad .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2018, 29 (09) :1287-1296
[2]   High-power short-duration versus standard radiofrequency ablation: Insights on lesion metrics [J].
Bourier, Felix ;
Duchateau, Josselin ;
Vlachos, Konstantinos ;
Lam, Anna ;
Martin, Claire A. ;
Takigawa, Masateru ;
Kitamura, Takeshi ;
Frontera, Antonio ;
Cheniti, Ghassen ;
Pambrun, Thomas ;
Klotz, Nicolas ;
Denis, Arnaud ;
Derval, Nicolas ;
Cochet, Hubert ;
Sacher, Frederic ;
Hocini, Meleze ;
Haissaguerre, Michel ;
Jais, Pierre .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2018, 29 (11) :1570-1575
[3]   Catheter ablation of atrial fibrillation using ablation index-guided high-power technique: Frankfurt AI high-power 15-month follow-up [J].
Chen, Shaojie ;
Schmidt, Boris ;
Bordignon, Stefano ;
Tohoku, Shota ;
Urban, Verena C. ;
Schulte-Hahn, Britta ;
Chun, K. R. Julian .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2021, 32 (03) :616-624
[4]   Ablation index-guided 50 W ablation for pulmonary vein isolation in patients with atrial fibrillation: Procedural data, lesion analysis, and initial results from the FAFA AI High Power Study [J].
Chen, Shaojie ;
Schmidt, Boris ;
Bordignon, Stefano ;
Urbanek, Lukas ;
Tohoku, Shota ;
Bologna, Fabrizio ;
Angelkov, Lazar ;
Garvanski, Iskren ;
Tsianakas, Nikolaos ;
Konstantinou, Athanasios ;
Trolese, Luca ;
Weise, Felix ;
Perrotta, Laura ;
Chun, K. R. Julian .
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2019, 30 (12) :2724-2731
[5]   Individualized cryoballoon energy pulmonary vein isolation guided by real-time pulmonary vein recordings, the randomized ICE-Ttrial [J].
Chun, K. R. Julian ;
Stich, Marie ;
Fuernkranz, Alexander ;
Bordignon, Stefano ;
Perrotta, Laura ;
Dugo, Daniela ;
Bologna, Fabrizio ;
Schmidt, Boris .
HEART RHYTHM, 2017, 14 (04) :495-500
[6]   Pulmonary Vein Reconnection No Longer Occurs in the Majority of Patients After a Single Pulmonary Vein Isolation Procedure [J].
De Pooter, Jan ;
Strisciuglio, Teresa ;
El Haddad, Milad ;
Wolf, Michael ;
Phlips, Thomas ;
Vandekerckhove, Yves ;
Tavernier, Rene ;
Knecht, Sebastien ;
Duytschaever, Mattias .
JACC-CLINICAL ELECTROPHYSIOLOGY, 2019, 5 (03) :295-305
[7]   Long-term impact of catheter ablation on arrhythmia burden in low-risk patients with paroxysmal atrial fibrillation: The CLOSE to CURE study [J].
Duytschaever, Mattias ;
De Pooter, Jan ;
Demolder, Anthony ;
El Haddad, Milad ;
Phlips, Thomas ;
Strisciuglio, Teresa ;
Debonnaire, Philippe ;
Wolf, Michael ;
Vandekerckhove, Yves ;
Knecht, Sebastien ;
Tavernier, Rene .
HEART RHYTHM, 2020, 17 (04) :535-543
[8]  
Heeger C.-H., 2018, Circ: Arrhythmia Electrophysiol., V8, P1088
[9]   Bonus-freeze: benefit or risk? Two-year outcome and procedural comparison of a "bonus-freeze" and "no bonus-freeze" protocol using the second-generation cryoballoon for pulmonary vein isolation [J].
Heeger, Christian-H. ;
Wissner, Erik ;
Wohlmuth, Peter ;
Mathew, Shibu ;
Hayashi, Kentaro ;
Sohns, Christian ;
Reissmann, Bruno ;
Lemes, Christine ;
Maurer, Tilman ;
Saguner, Ardan M. ;
Santoro, Francesco ;
Riedl, Johannes ;
Ouyang, Feifan ;
Kuck, Karl-Heinz ;
Metzner, Andreas .
CLINICAL RESEARCH IN CARDIOLOGY, 2016, 105 (09) :774-782
[10]   Short tip-big difference? First-in-man experience and procedural efficacy of pulmonary vein isolation using the third-generation cryoballoon [J].
Heeger, Christian-H. ;
Wissner, Erik ;
Mathew, Shibu ;
Hayashi, Kentaro ;
Sohns, Christian ;
Reissmann, Bruno ;
Lemes, Christine ;
Maurer, Tilmann ;
Fink, Thomas ;
Saguner, Ardan M. ;
Santoro, Francesco ;
Riedl, Johannes ;
Ouyang, Feifan ;
Kuck, Karl-Heinz ;
Metzner, Andreas .
CLINICAL RESEARCH IN CARDIOLOGY, 2016, 105 (06) :482-488