Very high-power and short-duration radiofrequency ablation for atrial fibrillation in a Latin American low-volume private center.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-01-23 DOI:10.1007/s10840-024-01756-4

Roberto Keegan, Francisco Garmendia, Franco Gregorietti, Ricardo Urruti, Leonardo Onetto

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Abstract

Background: Center volume and operator experience/training are important factors impacting outcomes in AFib CA. Setting for RF delivery (power, duration, and contact force) associated with better outcomes remains to be determined.

Methods: This is an observational, longitudinal, and retrospective study. All consecutive procedures performed between December 12, 2013, and March 9, 2023, in a low-volume private center in Latin America were analyzed. Procedure characteristics and outcomes were compared between STD and vHPSD.

Results: Two hundred ten procedures were performed on 194 patients. Median annual number of procedures was 19 (7-29). Median age was 62 (52-68), and majority were male (71%). Median procedure duration was 155 (125-195) min, mean fluoroscopy time 32.8 ± 15 min and mean fluoroscopy dose 373.5 ± 208.9 mGray. Median follow-up was 27 months, significantly longer in STD compared with vHPSD group (43 [31-68] vs. 13 [8-19], respectively; P ≤ 0.001). The recurrence rate was 33.2% and major complications 8.6%. Compared with STD, vHPSD resulted in a significantly shorter procedure duration (125 vs. 180 min, P ≤ 0.001), shorter fluoroscopy time (22.7 ± 9.5 vs. 39.2 ± 14.3 min, P ≤ 0.001), and lower fluoroscopy dose (283.8 ± 161.1 vs. 438.3 ± 216.1 mGray, P ≤ 0.001). No long-term recurrence difference was observed when the follow-up periods were comparable. No difference in complication rate was observed (8.5% vs. 8.6%, P = 0.988).

Conclusions: Outcomes in AFib CA in a Latin American low-volume private center can be considered acceptable, with efficacy and safety similar to those reported in the literature. Compared with STD ablation, vHPSD showed higher efficiency with similar efficacy and safety.

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拉丁美洲一家低容量私立中心的房颤超高功率短时射频消融术。

背景：中心容量和操作者的经验/培训是影响房颤 CA 治疗效果的重要因素。与更好疗效相关的射频治疗设置（功率、持续时间和接触力）仍有待确定：这是一项观察性、纵向和回顾性研究。方法：这是一项观察性、纵向和回顾性研究，分析了 2013 年 12 月 12 日至 2023 年 3 月 9 日期间在拉丁美洲一家低容量私立中心进行的所有连续手术。比较了 STD 和 vHPSD 的手术特征和结果：结果：共为 194 名患者实施了 210 例手术。每年手术的中位数为 19 例（7-29 例）。中位年龄为 62 岁（52-68 岁），大多数为男性（71%）。手术时间中位数为 155 (125-195) 分钟，平均透视时间为 32.8 ± 15 分钟，平均透视剂量为 373.5 ± 208.9 mGray。中位随访时间为27个月，STD组明显长于vHPSD组（分别为43 [31-68] vs. 13 [8-19]；P≤0.001）。复发率为33.2%，主要并发症为8.6%。与 STD 相比，vHPSD 明显缩短了手术时间（125 分钟对 180 分钟，P≤ 0.001），缩短了透视时间（22.7 ± 9.5 分钟对 39.2 ± 14.3 分钟，P≤ 0.001），降低了透视剂量（283.8 ± 161.1 mGray 对 438.3 ± 216.1 mGray，P≤ 0.001）。在随访时间相当的情况下，没有观察到长期复发的差异。并发症发生率无差异（8.5% vs. 8.6%，P = 0.988）：结论：拉丁美洲一家低容量私立中心的房颤 CA 治疗结果可以接受，疗效和安全性与文献报道相似。与 STD 消融术相比，vHPSD 的效率更高，疗效和安全性相似。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.