Identification of Predictors of Success During Atrial Fibrillation Ablation using High-Power Short-Duration.

Background: The study focused to identify markers of success in patients submitted to high-power short-duration (HPSD) atrial fibrillation (AF) ablation with contact force (CF) catheter. Methods: Prospective, observational study with 227 patients with first AF ablation in sinus rhythm using 50W of power and divided in two groups; success and failure according to absence or presence of AF related arrhythmias, respectively. Results: Success observed in 188 and failure in 39 patients, respectively. Median follow-up was 31±21.1 months. Left atrial time was shorter in success than in recurrence group (69.6±23.1 vs 83.2±21.2 min, p=0.008) as in total procedure time (80.1±30.2 vs 98.5±23.3min, (p=0.01). Radiofrequency time was 1,478±321.2 vs 1,888.4±584.1sec (p=0.001) in success and failure groups, respectively. Esophageal warming observed in 58 (30.9%) success and 14 (53.8%) recurrence patients (p=0.01). Higher rate of first-pass isolation observed in success than recurrence, 118 (77.6%) and 15 (50%) (p=0.039), respectively. After ablation heart rate increased from 53.8±9.7 to 66.8±11.6bpm in success and 57±7.7 to 64.4±10.4bpm in recurrence groups (p= 0.001), respectively. Conclusion: HPSD ablation identified that shorter left atrial time, lower luminal esophageal temperature heating, shorter radiofrequency time, higher heart rate increase and first-pass isolation effect were associated with better arrhythmia free-survival rates during follow-up. [ABSTRACT FROM AUTHOR]