Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis
The aim of this study was to compare the effectiveness and safety of very-high-power short-duration (VHPSD) ablation (70–90 W/4–7 s) with conventional ablation (30–40 W/>20 s, 50 W/7–11 s) for pulmonary vein isolation (PVI) in patients with AF. A total of 13 studies were included in this analysis...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2023-12-01
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| Series: | Arrhythmia & Electrophysiology Review |
| Online Access: | https://www.aerjournal.com/articleindex/aer.2023.19 |
| _version_ | 1797200014992211968 |
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| author | Raymond Pranata Giky Karwiky Mohammad Iqbal |
| author_facet | Raymond Pranata Giky Karwiky Mohammad Iqbal |
| author_sort | Raymond Pranata |
| collection | DOAJ |
| description | The aim of this study was to compare the effectiveness and safety of very-high-power short-duration (VHPSD) ablation (70–90 W/4–7 s) with conventional ablation (30–40 W/>20 s, 50 W/7–11 s) for pulmonary vein isolation (PVI) in patients with AF. A total of 13 studies were included in this analysis (1,527 patients). AF recurrence occurred in 14% (95% CI [11–18%]) of the VHPSD group. VHPSD was associated with lower AF recurrence (OR 0.65; 95% CI [0.48–0.89]; p=0.006) compared with the conventional ablation group. Subgroup analysis showed that additional ablation beyond PVI had a similar rate of AF recurrence (16% versus 10%) compared with PVI alone. Procedure and ablation durations were significantly shorter in the VHPSD group with a mean differences of –14.4 minutes (p=0.017) and −14.1 minutes (p<0.001), respectively. Complications occurred in 6% (95% CI [3–9%]) of the VHPSD group, and the rate was similar between the two groups (OR 1.03; 95% CI [0.60–1.80]; p=0.498). VHPSD ablation resulted in less AF recurrence and a shorter procedure time. Additional ablation beyond PVI alone in VHPSD may not provide additional benefits. |
| first_indexed | 2024-03-07T17:39:26Z |
| format | Article |
| id | doaj.art-dfc73859498b4587bdaf7fbf4b960077 |
| institution | Directory Open Access Journal |
| issn | 2050-3369 2050-3377 |
| language | English |
| last_indexed | 2024-04-24T07:24:55Z |
| publishDate | 2023-12-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Arrhythmia & Electrophysiology Review |
| spelling | doaj.art-dfc73859498b4587bdaf7fbf4b9600772024-04-20T16:03:47ZengRadcliffe Medical MediaArrhythmia & Electrophysiology Review2050-33692050-33772023-12-011210.15420/aer.2023.19Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysisRaymond Pranata0Giky Karwiky1Mohammad Iqbal2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, IndonesiaThe aim of this study was to compare the effectiveness and safety of very-high-power short-duration (VHPSD) ablation (70–90 W/4–7 s) with conventional ablation (30–40 W/>20 s, 50 W/7–11 s) for pulmonary vein isolation (PVI) in patients with AF. A total of 13 studies were included in this analysis (1,527 patients). AF recurrence occurred in 14% (95% CI [11–18%]) of the VHPSD group. VHPSD was associated with lower AF recurrence (OR 0.65; 95% CI [0.48–0.89]; p=0.006) compared with the conventional ablation group. Subgroup analysis showed that additional ablation beyond PVI had a similar rate of AF recurrence (16% versus 10%) compared with PVI alone. Procedure and ablation durations were significantly shorter in the VHPSD group with a mean differences of –14.4 minutes (p=0.017) and −14.1 minutes (p<0.001), respectively. Complications occurred in 6% (95% CI [3–9%]) of the VHPSD group, and the rate was similar between the two groups (OR 1.03; 95% CI [0.60–1.80]; p=0.498). VHPSD ablation resulted in less AF recurrence and a shorter procedure time. Additional ablation beyond PVI alone in VHPSD may not provide additional benefits.https://www.aerjournal.com/articleindex/aer.2023.19 |
| spellingShingle | Raymond Pranata Giky Karwiky Mohammad Iqbal Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis Arrhythmia & Electrophysiology Review |
| title | Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis |
| title_full | Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis |
| title_fullStr | Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis |
| title_full_unstemmed | Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis |
| title_short | Very-high-power Short-duration Ablation versus Conventional Ablation for Pulmonary Vein Isolation in Atrial Fibrillation: Systematic Review and Meta-analysis |
| title_sort | very high power short duration ablation versus conventional ablation for pulmonary vein isolation in atrial fibrillation systematic review and meta analysis |
| url | https://www.aerjournal.com/articleindex/aer.2023.19 |
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