The effectiveness of a high output/short duration radiofrequency current application technique in segmental pulmonary vein isolation for atrial fibrillation

Abstract

Aims: 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. Methods and 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°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°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. Conclusion: 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. © 2006 Oxford University Press.