Implementation of Zero-Fluoroscopy High-Power Short-Duration
Radiofrequency Catheter Ablation for Atrial Fibrillation
- Guang-an LIU
, - Feng LIU
Guang-an LIU
![](https://d197for5662m48.cloudfront.net/assets/icons/omniauth/orcid-ca37582cd91a671ed5cec57770e0e96c01b4b79b8b5b75d8598fc1ddac18c974.svg)
Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine
Author ProfileAbstract
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Introduction High-power short-duration(HPSD) radiofrequency
catheter ablation(RFCA) for atrial fibrillation(AF) has been gradually
applied in clinical practice.However,the efficacy and safety of HPSD
compared to traditional low-power long-duration (LPLD) ablation are not
definitive conclusion. In addition, Zero-fluoroscopy catheter ablation
technique has also emerged as a novel method in present ,However
research on the combination of zero-fluoroscopy procedure with HPSD
catheter ablation for AF are unknown. Objective To evaluate the
efficacy and safety of HPSD and LPLD using intracardiac echocardiography
(ICE) combined with electroanatomic mapping (EAM) reconstruction for
zero-fluoroscopy during RFCA for AF. Methods A total of 173
patients undergoing RFCA for AF were divided into a HPSD(45-50w) group
(n=87) and a LPLD (30-35w)group (n=86). The procedure was performed
using ICE combined with EAM to achieve zero-fluoroscopy. Both groups
underwent routine pulmonary vein isolation(PVI) .There are additional
linear ablations for persistent AF at the left atrial roof line, left
atrial posterior wall line, mitral isthmus line, and tricuspid isthmus
line if necessary. The duration of the procedures, efficacy, short-term
and one year successful rates, as well as procedure complications were
compared between the two groups. Results The procedure time and
ablation time in the HPSD group were significantly shorter than those in
the LPLD group(115.8±30.8 vs 130.5±26.3, P =0.001; 14.9±2.3 vs 30.0±4.1,
P =.000). There was no difference between the two groups in terms of TSP
time(50.0±10.9 vs 51.7±9.0, P =0.273), immediate success rate of
PVI(100% vs 100%, P =1.000), single-loop isolation rate of PVI(98.9%
vs 95.3%, P =.169), and number of ablation points(71.6±8.4 vs
74.2±14.6, P =.159). At 12 months follow-up, sinus rhythm was maintained
in 77 cases in the HPSD group and 74 cases in the LPLD group with no
significant difference between them (88.5% vs 86.0%, P =.583). There
were 5 and 3 complications in the HPSD group and the LPLD group,
respectively, with no difference between the two groups(3.4% vs 5.8%,
P =.459). There were no stroke,esophageal atrial fistulae or deaths in
either group. Conclusion ICE combined with EAM guidance for
zero-fluoroscopy HPSD catheter ablation for atrial fibrillation is safe,
reliable and repeatable, and the 1-year success rate is similar to that
of traditional power, with a trend of improvement.