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Comparison of outcomes with low-power long duration versus high-power short duration of ablation: the role of the acute change in sinus rhythm after the ablation as a predictor of long-term success

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Abstract

Different results are described after atrial fibrillation ablation and multiple predictors of recurrence are well established. Evaluate and analyze if heart rate increase (HRI) during a first atrial fibrillation (AF) ablation with low-power long-duration (LPLD) and subsequently with high-power short-duration (HPSD) can impact. Retrospectively analyzed 340 consecutive patients (pts) undergoing first AF ablation. There were 158 pts in LPLD group: 113 (71.5%) paroxysmal AF with ablation with a power of 30/20 w, on anterior and posterior left atrial (LA) wall, respectively, and contact force of 10–30g for 30 s. There were 182 pts in HPSD group: 106 (58.2%) paroxysmal AF, who underwent ablation with 45/50 w, contact force of 8–15g/10–20g and 35 mL/min flow rate on anterior and posterior left atrial wall, respectively. Median follow-up was 32 ± 16 months. Success was observed in 94 (59.5%) patients in LPLD and 152 (83.5%) in HPSD, in LPLD group we documented a median HRI of 4.3 bpm (8%), compared to preablation heart rate, while a higher HRI in HPSD group of HRI 13.5 bpm (27.2%) was noted. Heart rate increase was associated with a higher success rate in both ablation techniques and independently showed an important impact on the success rate after AF ablation. HPSD compared to LPLD showed a higher proportion of HRI and also demonstrated a superiority in maintaining sinus rhythm at a long-term follow-up.

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Acknowledgements

We acknowledge Christiane Amaral from the administrative staff, as well as Edevaldo da Silva, Anderson Barcelos and Bruno Oliveira from the biomedical team, for their dedication, patience, and data collection efforts

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This study received no financial support

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Authors and Affiliations

  1. Hospital Santa Rita de Cássia, AFECC, Vitória, Brazil

    Fabricio Vassallo, Lucas Luis Meigre, Christiano Cunha, Eduardo Serpa, Aloyr Simoes Jr., Carlos Lovatto, Dalbian Gasparini & Lucas Corcino

  2. Hospital Santa Casa de Misericórdia de Vitória, Vitória, Brazil

    Fabricio Vassallo, Christiano Cunha, Eduardo Serpa, Aloyr Simoes Jr., Carlos Lovatto & Dalbian Gasparini

  3. Disciplina de Clínica Médica da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, Brazil

    Fabricio Vassallo, Lucas Corcino & Andre Schmidt

  4. Instituto de Cardiologia do Espirito Santo, Rua José Alexandre Buaiz, 350 Edificio Affinity Work, Sala 1602, Enseada do Suá, Vitória, ES, Brazil

    Fabricio Vassallo

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  1. Fabricio Vassallo
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Vassallo, F., Meigre, L.L., Cunha, C. et al. Comparison of outcomes with low-power long duration versus high-power short duration of ablation: the role of the acute change in sinus rhythm after the ablation as a predictor of long-term success. Heart Vessels 37, 1749–1756 (2022). https://doi.org/10.1007/s00380-022-02066-3

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