Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Endowed Associate Professor
|Title||Efficacy and Safety of High-Power RF Ablation for Pulmonary Vein Isolation: A Comparative Study with Conventional RF Ablation|
|Conference||The 66th Annual Meeting of The Japanese Heart Rhythm Society|
|Promoters||Japanese Heart Rhythm Society|
|Conference Type||Nationwide Conferences|
|Publisher and common publisher||◎YAZAKI Kyoichiro, EJIMA Koichiro, HIGUCHI Satoshi, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa|
(city and name of the country)
|Summary||*Young Investigator Award (YIA) Competition
Background: Recently developed high-power (HP) RF ablation for atrial fibrillation (AF) has not been well investigated. We studied acute efficacy and safety of HP-RF as compared with a conventional method.
Methods: The consecutive 64 patients with AF (51 paroxysmal; 13 persistent) who underwent pulmonary vein isolation (PVI) were included. Applied RF energy was 25-40W in conventional RF group (C-G), and 50W in HP-RF group (HP-G). HP-RF was applied to each site for 5-10 sec under esophageal temperature monitoring. The ablation lesion measured by 3-D CARTO mapping and the result of PVI were compared between two groups, retrospectively.
Results: The length of bilateral isolation lines was not significantly different between C-G and HF-G (235 ± 24 mm versus 243 ± 37 mm, p = 0.25) and the acute PV reconnection (PVR) was also not different (88% versus 69%, p = 0.13).
The product of RF time and RF energy (45 ± 12 kJ versus 29 ± 18 kJ, p < 0.0001), the RF application time (24 ± 6 min versus 10 ± 3 min, p < 0.0001) and bilateral isolation time (48 ± 16 min versus 26 ± 10 min, p < 0.0001) were significantly smaller in HP-G. Remarkable impedance changes, pop-sounds and char formations were not identified. Acute right phrenic nerve palsy was observed in 1 patient of HPG.
Conclusions: HP-RF ablation could reduce the amount of RF energy and RF time, however, the acute PVR of HP-RF was similar to conventional RF ablation. Also, further investigation for the safety of HP-RF ablation was considered to be required.