Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
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
Presentation Type Speech
Publisher and common publisher◎YAZAKI Kyoichiro, EJIMA Koichiro, HIGUCHI Satoshi, YAGISHITA Daigo, SHODA Morio, HAGIWARA Nobuhisa
Date 2019/07/25
(city and name of the country)
Yokohama, JAPAN
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.