Comparison of outcomes with low-power long duration versus high-power short duration of ablation: the role of the acute change in sinus rhythm after the ablation as a predictor of long-term success.

Autor: Vassallo F; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil. fvassallo@usp.br.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil. fvassallo@usp.br.; Disciplina de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil. fvassallo@usp.br.; Instituto de Cardiologia do Espirito Santo, Rua José Alexandre Buaiz, 350 Edificio Affinity Work, Sala 1602, Enseada do Suá, Vitória, ES, Brazil. fvassallo@usp.br., Meigre LL; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil., Cunha C; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil., Serpa E; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil., Simoes A Jr; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil., Lovatto C; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil., Gasparini D; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil., Corcino L; Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil.; Disciplina de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil., Schmidt A; Disciplina de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil.
Jazyk: angličtina
Zdroj: Heart and vessels [Heart Vessels] 2022 Oct; Vol. 37 (10), pp. 1749-1756. Date of Electronic Publication: 2022 Apr 16.
DOI: 10.1007/s00380-022-02066-3
Abstrakt: Different results are described after atrial fibrillation ablation and multiple predictors of recurrence are well established. Evaluate and analyze if heart rate increase (HRI) during a first atrial fibrillation (AF) ablation with low-power long-duration (LPLD) and subsequently with high-power short-duration (HPSD) can impact. Retrospectively analyzed 340 consecutive patients (pts) undergoing first AF ablation. There were 158 pts in LPLD group: 113 (71.5%) paroxysmal AF with ablation with a power of 30/20 w, on anterior and posterior left atrial (LA) wall, respectively, and contact force of 10-30g for 30 s. There were 182 pts in HPSD group: 106 (58.2%) paroxysmal AF, who underwent ablation with 45/50 w, contact force of 8-15g/10-20g and 35 mL/min flow rate on anterior and posterior left atrial wall, respectively. Median follow-up was 32 ± 16 months. Success was observed in 94 (59.5%) patients in LPLD and 152 (83.5%) in HPSD, in LPLD group we documented a median HRI of 4.3 bpm (8%), compared to preablation heart rate, while a higher HRI in HPSD group of HRI 13.5 bpm (27.2%) was noted. Heart rate increase was associated with a higher success rate in both ablation techniques and independently showed an important impact on the success rate after AF ablation. HPSD compared to LPLD showed a higher proportion of HRI and also demonstrated a superiority in maintaining sinus rhythm at a long-term follow-up.
(© 2022. Springer Japan KK, part of Springer Nature.)
Databáze: MEDLINE