Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

Comparative efficacy and safety profile of high-power short duration with low power long duration radiofrequency ablation in atrial fibrillation: An updated systematic review and meta-analysis
  • +9
  • Satesh Kumar,
  • Mahima Khatri,
  • Sumeet kumar,
  • Partab FNU,
  • Manoj Kumar FNU,
  • Neha FNU,
  • Suman FNU,
  • Lajpat Rai,
  • Sangam FNU,
  • Simran Kumari,
  • Hamza Islam,
  • Rabia Islam
Satesh Kumar
Shaheed Mohtarma Benazir Bhutto Medical College

Corresponding Author:[email protected]

Author Profile
Mahima Khatri
Dow University of Health Sciences
Author Profile
Sumeet kumar
Dow University of Health Sciences
Author Profile
Partab FNU
Chandka Medical College
Author Profile
Manoj Kumar FNU
Jinnah Sindh Medical University
Author Profile
Neha FNU
Shaheed Montarma Benazir Bhutto Medical University Ghulam Muhammad Mahar Medical College
Author Profile
Suman FNU
Chandka Medical College
Author Profile
Lajpat Rai
Liaquat University of Medical and Health Sciences
Author Profile
Sangam FNU
Dow University of Health Sciences
Author Profile
Simran Kumari
Chandka Medical College
Author Profile
Hamza Islam
Punjab Medical College
Author Profile
Rabia Islam
Punjab Medical College
Author Profile

Abstract

Background: High power short duration (HPSD) radiofrequency ablation was expected to be more effective and safer than low power long duration (LPLD) in treating atrial fibrillation (AF). Given the limited data, the findings were controversial. This meta-analysis evaluated whether HPSD’s clinical effects outweigh LPLD’s. Methods: A systematic search of PubMed, EMBASE, and Google Scholar databases identified studies comparing HPSD to LPLD ablation. All the analyses used the random-effects model. Results: This analysis included 21 studies with a total of 4169 patients. Pooled analyses revealed that HPSD was associated with a lower recurrence of atrial tachyarrhythmias (ATAs) at one year (RR: 0.62; 95% CI: 0.50 to 0.78, p: 0.00001, I 2: 0%). Furthermore, the HPSD approach reduced the risk of AF recurrence (RR: 0.64; 95% CI: 0.40 to 1.01, p: 0.06, I 2: 86%), The HPSD approach was associated with a lower risk of esophageal thermal injury (ETI) (RR: 0.78; 95% CI: 0.58 to 1.04, p: 0.09, I 2: 73%;). The HPSD strategy increased first-pass pulmonary vein isolation (FPI) and decreased acute pulmonary vein re-connection (PVR) both of which were predominantly manifested in bilateral and left pulmonary veins (PVs). HPSD demonstrated a reduction in procedural time, ablation number for pulmonary vein isolation (PVI), and fluoroscopy time. Conclusion: The HPSD method reduces ETI, PV reconnection, and recurrent AF. The HPSD approach also reduced procedural time, PVI ablation number, fluoroscopy time, and post-ablation AF relapse in one year, improving patient outcomes and safety.