Comparison of outcomes with low-power long duration versus high-power short duration of ablation: the role of the acute change in sinus rhythm after the ablation as a predictor of long-term success

Vassallo, Fabrício; Meigre, Lucas Luis; Cunha, Christiano; Serpa, Eduardo; Simões, Aloyr; Lovatto, Carlos; Gasparini, Dalbian; Corcino, Lucas; Schmidt, André

doi:10.1007/s00380-022-02066-3

Cited by 2 publications

(1 citation statement)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The literature review initially yielded 1,050 articles. After removing duplicates and screening studies based on their titles and abstracts, a total of 21 12 – 32 studies, including both retrospective and prospective studies, were found. Comparative studies composed the entirety of those included in this meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Comparative Efficacy and Safety Profiles of High-power, Short-duration and Low-power, Long-duration Radiofrequency Ablation in Atrial Fibrillation: A Systematic Review and Meta-analysis

KUMAR,

KHATRI,

KUMAR

et al. 2023

J Innov Cardiac Rhythm Manage.

View full text Add to dashboard Cite

High-power, short-duration (HPSD) radiofrequency (RF) ablation is expected to be more effective and safer than low-power, long-duration (LPLD) RF ablation in treating atrial fibrillation (AF). Given the limited data available, the findings are controversial. This meta-analysis evaluated whether the clinical effects of HPSD outweigh those of LPLD. 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. This analysis included 21 studies with a total of 4,169 patients. Pooled analyses revealed that HPSD was associated with a lower recurrence of atrial tachyarrhythmias (ATAs) at 1 year (relative risk [RR], 0.62; 95% confidence interval [CI], 0.50–0.78; P = .00001; I 2 = 0%). Furthermore, the HPSD approach reduced the risk of AF recurrence (RR, 0.64; 95% CI, 0.40–1.01; P = .06; I 2 = 86%). The HPSD approach was associated with a lower risk of esophageal thermal injury (ETI) (RR, 0.78; 95% CI, 0.58–1.04; P = .09; I 2 = 73%). The HPSD strategy increased first-pass pulmonary vein (PV) isolation (PVI) and decreased acute PV reconnection (PVR), both of which were predominantly manifested in bilateral and left PVs. HPSD facilitated a reduction in procedural time, number of lesions created during PVI, and fluoroscopy time. The HPSD method reduces ETI, PVR, and recurrent AF. The HPSD approach also reduced the procedural time, number of lesions created during PVI, fluoroscopy time, and post-ablation AF relapse in 1 year, improving patient outcomes and safety.

show abstract

Section: Resultsmentioning

confidence: 99%