The First-Pass Isolation Effect in High-Power Short-Duration Compared to Low-Power Long-Duration Atrial Fibrillation Ablation: a Predictor of Success

Autor: Fabricio Vassallo, Lucas Luis Meigre, Eduardo Serpa, Carlos Lovatto, Christiano Cunha, Hermes Carloni, Aloyr Simoes Jr. Simoes Jr., Karla Meira, Flávia Pezzin, Orly Lacerda Jr., Walter Batista Jr., Alberto Nogueira Jr., Dalton Amaral
Jazyk: English<br />Portuguese
Rok vydání: 2020
Předmět:
Zdroj: Journal of Cardiac Arrhythmias, Vol 33, Iss 3 (2020)
Druh dokumentu: article
ISSN: 2674-7472
Popis: Introduction: Different results are described after atrial fibrillation ablation and multiples predictors of recurrence are well established. Objective: Evaluate and analyze if first-pass isolation effect (FPI) during first atrial fibrillation (AF) ablation with high-power short-duration (HPSD) comparing to low-power long-duration (LPLD) can impact on late outcome. Methods: Observational, retrospective study, 144 patients submitted to HPSD and LPLD ablation. HPSD: 71 patients, 50 (70.42%) males, mean age 59.73 years, 52 (73.24%) hypertension, 44 (61.97%) obstructive apnea, 23 (32.39%) arterial disease, 20 (28.17%) diabetes, and 10(14.08%) stroke. CHADS2VASC2 2.57. CT: 73 patients, 50 (68.49%) males, mean age 60.7 years, 53 (72.60%) hypertension, 41 (56.16%) obstructive apnea, 28 (38.36%) arterial disease, 14 (19.17%) diabetes and 8 (10.96%) stroke. CHAD2SVASC2 2.22. Results: Recurrence occurred in 33 patients (22.92%) at 12 months follow-up, HPSD with 9 patients and LPLD with 24 patients. Higher rate of bilateral FPI were observed in HPSD patients with 62 of 71 patients comparing to 17 of 73 patients in LPLD (P < 0.00001). At the end of study 62 (87.32%) of 71 HPSD patients were in sinus rhythm comparing to 49 (67.12%) of 73 patients in LPLD (P 0.0039). Conclusion: HPSD ablation produced higher rates of FPI comparing to LPLD. HPSD compared to LPLD showed a superiority in maintaining sinus rhythm at 12 months. At patients submitted to HPSD protocol ablation, FPI could predict higher rate of sinus rhythm at 12 months follow-up.
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