The First-Pass Isolation Effect in High-Power Short-Duration Compared to Low-Power Long-Duration Atrial Fibrillation Ablation: a Predictor of Success

Authors

  • Fabricio Vassallo Instituto de Cardiologia do Espírito Santo – Vitória (ES), Brazil;  Hospital Santa Rita de Cassia – Vitória (ES), Brazil and; Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Lucas Luis Meigre Instituto de Cardiologia do Espírito Santo – Vitória (ES), Brazil
  • Eduardo Serpa Instituto de Cardiologia do Espírito Santo – Vitória (ES), Brazil;  Hospital Santa Rita de Cassia – Vitória (ES), Brazil and; Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Carlos Lovatto Hospital Santa Rita de Cassia – Vitória (ES), Brazil and Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Christiano Cunha Hospital Santa Rita de Cassia – Vitória (ES), Brazil and Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Hermes Carloni Hospital Santa Rita de Cassia – Vitória (ES), Brazil and Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Aloyr Simoes Jr. Simoes Jr. Hospital Santa Rita de Cassia – Vitória (ES), Brazil and Hospital Santa Casa de Misericórdia – Vitória (ES), Brazil.
  • Karla Meira Instituto de Cardiologia do Espírito Santo – Vitória (ES), Brazil and  Hospital Santa Rita de Cassia – Vitória (ES), Brazil.
  • Flávia Pezzin Instituto de Cardiologia do Espírito Santo – Vitória (ES), Brazil and  Hospital Santa Rita de Cassia – Vitória (ES), Brazil.
  • Orly Lacerda Jr. Hospital Santa Rita de Cassia – Vitória (ES), Brazil.
  • Walter Batista Jr. Hospital Santa Rita de Cassia – Vitória (ES), Brazil.
  • Alberto Nogueira Jr. Hospital Santa Rita de Cassia – Vitória (ES), Brazil.
  • Dalton Amaral Hospital Santa Rita de Cassia – Vitória (ES), Brazil.

Keywords:

Atrial fibrillation, Atrial tachyarrhythmias, Recurrence rate, First-pass isolation, Atrial fibrillation ablation

Abstract

Introduction: Different results are described after atrial fibrillation ablation and multiples predictors of recurrence are well established. Objective: Evaluate and analyze if first-pass isolation effect (FPI) during first atrial fibrillation (AF) ablation with high-power short-duration (HPSD) comparing to low-power long-duration (LPLD) can impact on late outcome. Methods: Observational, retrospective study, 144 patients submitted to HPSD and LPLD ablation. HPSD: 71 patients, 50 (70.42%) males, mean age 59.73 years, 52 (73.24%) hypertension, 44 (61.97%) obstructive apnea, 23 (32.39%) arterial disease, 20 (28.17%) diabetes, and 10(14.08%) stroke. CHADS2VASC2 2.57. CT: 73 patients, 50 (68.49%) males, mean age 60.7 years, 53 (72.60%) hypertension, 41 (56.16%) obstructive apnea, 28 (38.36%) arterial disease, 14 (19.17%) diabetes and 8 (10.96%) stroke. CHAD2SVASC2 2.22. Results: Recurrence occurred in 33 patients (22.92%) at 12 months follow-up, HPSD with 9 patients and LPLD with 24 patients. Higher rate of bilateral FPI were observed in HPSD patients with 62 of 71 patients comparing to 17 of 73 patients in LPLD (P < 0.00001). At the end of study 62 (87.32%) of 71 HPSD patients were in sinus rhythm comparing to 49 (67.12%) of 73 patients in LPLD (P 0.0039). Conclusion: HPSD ablation produced higher rates of FPI comparing to LPLD. HPSD compared to LPLD showed a superiority in maintaining sinus rhythm at 12 months. At patients submitted to HPSD protocol ablation, FPI could predict higher rate of sinus rhythm at 12 months follow-up.

 

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Published

2020-11-06

How to Cite

Vassallo, F., Meigre, L. L. ., Serpa, E. ., Lovatto, C. ., Cunha, C. ., Carloni, H. ., Simoes Jr., A. S. J., Meira, K., Pezzin, F. ., Lacerda Jr., O. ., Batista Jr., W. ., Nogueira Jr., A. ., & Amaral, D. (2020). The First-Pass Isolation Effect in High-Power Short-Duration Compared to Low-Power Long-Duration Atrial Fibrillation Ablation: a Predictor of Success. JOURNAL OF CARDIAC ARRHYTHMIAS, 33(3), 161–169. Retrieved from https://jca.emnuvens.com.br/jca/article/view/3406

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