PDF(Pubmed)
Abstract：
UNASSIGNED: Pulmonary vein isolation (PVI) ablation is the established gold standard therapy for patients with symptomatic drug refractory atrial fibrillation (AF). Advancements in radiofrequency (RF) ablation, have led to the development of the novel contact force-sensing temperature-controlled very high-power short-duration (vHPSD) RF ablation. This setting delivers 90 W for up to 4 seconds with a constant irrigation flow rate of 8 mL/min. The aim of this study was to compare procedural outcomes and safety with conventional radiofrequency ablation.
UNASSIGNED: An observational study was conducted with patients who underwent first time PVI ablation between August 2020 and January 2022. The cohort was divided into: (1) vHPSD ablation; (2) High-power short duration (HPSD) ablation; (3) THERMOCOOL SMARTTOUCH™ SF (STSF). The vHPSD ablation group was prospectively recruited while the HPSD and STSF group were retrospectively collected. Primary outcomes were procedural success, PVI duration, ablation duration and incidence of perioperative adverse events. Secondary outcomes were intraprocedural morphine and midazolam requirement.
UNASSIGNED: A total of 175 patients were included in the study with 100, 30 and 45 patients in the vHPSD, HPSD and STSF group, respectively. PVI was successfully attained in all vHPSD patients. vHPSD demonstrated significantly reduced time required for PVI and total energy application in comparison to the HPSD and STSF groups (67.7 ± 29.7 vs. 92.9 ± 25.7 vs. 93.6 ± 29.1 min, p < 0.0001; 9.87 ± 4.16 vs. 33.9 ± 7.49 vs. 36.0 ± 10.5 min, p < 0.0001, respectively). Intravenous morphine and midazolam requirement was lower in the vHPSD group compared to the HPSD and STSF groups (10.2 ± 3.43 vs. 16.1 ± 4.58 vs. 15.3 ± 3.94 mg, p < 0.0001; 4.04 ± 3.24 vs. 8.63 ± 5.22 vs. 8.58 ± 4.72 mg, p < 0.0001). One cardiac tamponade was observed in both the vHPSD and HPSD groups while the STSF group exhibited an embolic stoke and two pericardial effusions that did not require drainage.
UNASSIGNED: In this study, vHPSD demonstrated a comparable safety profile to the other treatment arms. Procedural duration and energy application time was substantially reduced along with sedation requirement notwithstanding the limitations of observational study design, these preliminary findings are promising with respect to periprocedural outcomes and safety of vHPSD however longitudinal outcomes will be essential to assessing the overall efficacy of this novel technology.
UNASSIGNED: An observational study was conducted with patients who underwent first time PVI ablation between August 2020 and January 2022. The cohort was divided into: (1) vHPSD ablation; (2) High-power short duration (HPSD) ablation; (3) THERMOCOOL SMARTTOUCH™ SF (STSF). The vHPSD ablation group was prospectively recruited while the HPSD and STSF group were retrospectively collected. Primary outcomes were procedural success, PVI duration, ablation duration and incidence of perioperative adverse events. Secondary outcomes were intraprocedural morphine and midazolam requirement.
UNASSIGNED: A total of 175 patients were included in the study with 100, 30 and 45 patients in the vHPSD, HPSD and STSF group, respectively. PVI was successfully attained in all vHPSD patients. vHPSD demonstrated significantly reduced time required for PVI and total energy application in comparison to the HPSD and STSF groups (67.7 ± 29.7 vs. 92.9 ± 25.7 vs. 93.6 ± 29.1 min, p < 0.0001; 9.87 ± 4.16 vs. 33.9 ± 7.49 vs. 36.0 ± 10.5 min, p < 0.0001, respectively). Intravenous morphine and midazolam requirement was lower in the vHPSD group compared to the HPSD and STSF groups (10.2 ± 3.43 vs. 16.1 ± 4.58 vs. 15.3 ± 3.94 mg, p < 0.0001; 4.04 ± 3.24 vs. 8.63 ± 5.22 vs. 8.58 ± 4.72 mg, p < 0.0001). One cardiac tamponade was observed in both the vHPSD and HPSD groups while the STSF group exhibited an embolic stoke and two pericardial effusions that did not require drainage.
UNASSIGNED: In this study, vHPSD demonstrated a comparable safety profile to the other treatment arms. Procedural duration and energy application time was substantially reduced along with sedation requirement notwithstanding the limitations of observational study design, these preliminary findings are promising with respect to periprocedural outcomes and safety of vHPSD however longitudinal outcomes will be essential to assessing the overall efficacy of this novel technology.
摘要：
■肺静脉隔离（PVI）消融是有症状的药物难治性心房颤动（AF）患者的既定金标准疗法。射频（RF）消融的进展，导致了新型接触力传感温度控制的极高功率短时（vHPSD）射频消融的发展。此设置提供90W长达4秒的恒定冲洗流速为8mL/min。这项研究的目的是比较常规射频消融的手术结果和安全性。
■对2020年8月至2022年1月首次接受PVI消融的患者进行了一项观察性研究。队列分为：（1）vHPSD消融；（2）高功率短持续时间（HPSD）消融；（3）THERMOCOOLSMARTTOUCH™SF（STSF）。前瞻性招募vHPSD消融组，而回顾性收集HPSD和STSF组。主要结果是程序成功，PVI持续时间,消融时间和围手术期不良事件发生率。次要结果是术中吗啡和咪达唑仑的需求。
■本研究共纳入175例患者，其中vHPSD患者分别为100、30和45例，HPSD和STSF组，分别。所有vHPSD患者均成功达到PVI。与HPSD和STSF组相比，vHPSD显示出PVI和总能量应用所需的时间显着减少（67.7±29.7vs.92.9±25.7vs.93.6±29.1min,p<0.0001;9.87±4.16vs.33.9±7.49vs.36.0±10.5min,p分别<0.0001)。与HPSD和STSF组相比，vHPSD组的静脉吗啡和咪达唑仑需求较低（10.2±3.43vs.16.1±4.58vs.15.3±3.94毫克，p<0.0001;4.04±3.24vs.8.63±5.22vs.8.58±4.72毫克，p<0.0001)。在vHPSD和HPSD组均观察到一次心脏压塞，而STSF组表现出栓塞性中风和两次不需要引流的心包积液。
■在这项研究中，vHPSD表现出与其他治疗组相当的安全性。尽管存在观察性研究设计的局限性，但手术持续时间和能量应用时间均大大减少，同时需要镇静。这些初步发现在vHPSD的围手术期结局和安全性方面是有希望的,但纵向结局对于评估这项新技术的整体疗效至关重要.
■对2020年8月至2022年1月首次接受PVI消融的患者进行了一项观察性研究。队列分为：（1）vHPSD消融；（2）高功率短持续时间（HPSD）消融；（3）THERMOCOOLSMARTTOUCH™SF（STSF）。前瞻性招募vHPSD消融组，而回顾性收集HPSD和STSF组。主要结果是程序成功，PVI持续时间,消融时间和围手术期不良事件发生率。次要结果是术中吗啡和咪达唑仑的需求。
■本研究共纳入175例患者，其中vHPSD患者分别为100、30和45例，HPSD和STSF组，分别。所有vHPSD患者均成功达到PVI。与HPSD和STSF组相比，vHPSD显示出PVI和总能量应用所需的时间显着减少（67.7±29.7vs.92.9±25.7vs.93.6±29.1min,p<0.0001;9.87±4.16vs.33.9±7.49vs.36.0±10.5min,p分别<0.0001)。与HPSD和STSF组相比，vHPSD组的静脉吗啡和咪达唑仑需求较低（10.2±3.43vs.16.1±4.58vs.15.3±3.94毫克，p<0.0001;4.04±3.24vs.8.63±5.22vs.8.58±4.72毫克，p<0.0001)。在vHPSD和HPSD组均观察到一次心脏压塞，而STSF组表现出栓塞性中风和两次不需要引流的心包积液。
■在这项研究中，vHPSD表现出与其他治疗组相当的安全性。尽管存在观察性研究设计的局限性，但手术持续时间和能量应用时间均大大减少，同时需要镇静。这些初步发现在vHPSD的围手术期结局和安全性方面是有希望的,但纵向结局对于评估这项新技术的整体疗效至关重要.
