High-power, short duration radiofrequency ablation may achieve pulmonary vein isolation faster in AF

Pulmonary vein isolation is a common procedure to treat atrial fibrillation (Afib). Atrial fibrillation is an abnormal heart rhythm (arrhythmia) that occurs in the atrium. When left untreated, atrial fibrillation can lead to consequences such as stroke and heart attack.

High-power, short duration (HPSD) radiofrequency ablation (RFA) is a commonly used strategy for pulmonary vein isolation (PVI). A study suggests HPSD is reliable method to achieve pulmonary vein isolation compared to standard power, standard duration RFA but is an increased risk of Asymptomatic Cerebral Emboli (ACE).

A recent study aimed to compare HPSD with standard power, standard duration (SPSD) RFA in patients undergoing PVI. The study is published in JACC: Clinical Electrophysiology.

Researchers included patients with paroxysmal or persistent (<1 year) atrial fibrillation (AF) were randomized to HPSD (50 W) or SPSD (25-30 W) RFA to achieve PVI. Outcomes assessed included time to achieve PVI (primary), left atrial dwell time, total procedure time, first-pass isolation, Pulmonary Vein (PV) reconnection with adenosine, procedure complications including asymptomatic cerebral emboli (ACE), and freedom from atrial arrhythmias.