The effectiveness of a high output/short duration radiofrequency current application technique in segmental pulmonary vein isolation for atrial fibrillation.
OBJECTIVE
Segmental pulmonary vein (PV) isolation by radiofrequency (RF) catheter ablation has become a curative therapy for atrial fibrillation (AF). However, the long procedure time limits the wide application of this procedure. The aim of the current study was to compare a novel ablation technique with a high power output and short application time vs. a conventional technique using a low power output and long application time.


RESULTS
The study included 90 consecutive patients (age 53+/-10 years; 66 men). Segmental PV isolation was performed by irrigated RF catheter ablation in both groups. In the conventional group (Group 1, 45 patients), the power output was limited to 30 W with a target temperature of 50 degrees C and an RF preset duration of 120 s. In the novel group (Group 2, 45 patients), the maximum power output was preset to 45 W, with a target temperature of 55 degrees C and duration of 20 s. In Group 2, a significant reduction in the PV isolation time (127+/-57 vs. 94+/-33 min, P<0.02), mean fluoroscopy time (73+/-23 vs. 55+/-16 min, P<0.001), and radiation dose was observed. According to the application time and number, Group 2 showed a reduction in RF application time, but a higher number of RF applications were required for creation of complete PV isolation. During a mean follow-up of 15+/-7 months, a total of 74% of patients in Group 1 and 76% of patients in Group 2 demonstrated stable SR.


CONCLUSIONS
Segmental PV isolation using a high power output and short application time is safe and effective in PV isolation in patients with AF. This technique can significantly reduce the procedure and fluoroscopy time compared with a low-power output technique.
Nilsson
Brian
B
Medical Department B, Department of Cardiology, The Heart Centre, Cardiac Catheterization Laboratory, Rigshospitalet, Copenhagen University Hospital, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. brni@dadlnet.dk
Chen
Xu
X
Pehrson
Steen
S
Svendsen
Jesper Hastrup
JH
D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D016896:Treatment Outcome