TY - JOUR
T1 - Efficacy and Safety of High-Power Short-Duration Ablation for Cavo-Tricuspid Isthmus With a Flexible-Tip Temperature-Controlled Power Regulation Catheter Performed by Electrophysiology Trainees
AU - Iwakawa, Hidehiro
AU - Takigawa, Masateru
AU - Nakada, Kosuke
AU - Yamamoto, Tasuku
AU - Ikenouchi, Takashi
AU - Masumura, Mayumi
AU - Negishi, Miho
AU - Kawamura, Iwanari
AU - Goto, Kentaro
AU - Shigeta, Takatoshi
AU - Nishimura, Takuro
AU - Takamiya, Tomomasa
AU - Tao, Susumu
AU - Miyazaki, Shinsuke
AU - Goya, Masahiko
AU - Watanabe, Hiroyuki
AU - Sasano, Tetsuo
N1 - Publisher Copyright:
© 2024 Wiley Periodicals LLC.
PY - 2024
Y1 - 2024
N2 - Introduction: The suitability of high-power short-duration (HPSD) cavo-tricuspid isthmus ablation (CTI-Abl) for electrophysiology (EP) trainees, as well as the underlying mechanisms of its efficacy, remain unknown. The aim of this study was to clarify the efficacy and safety of HPSD CTI-Abl performed by EP trainees and assess lesion characteristics between HPSD and moderate-power long duration (MPLD) ablations. Methods: Study 1: CTI-Abl was performed by first- to fourth-year EP trainees in consecutive 113 patients (67 ± 11 years, 27.2% female). Study cohort was historically divided into three groups: MPLD (30–35 W for up to 30 s) using TactiCath (TC-MPLD, N = 38) and MPLD and HPSD (50 W for 12 s) using TactiFlex (TF-MPLD, N = 23; TF-HPSD, N = 52). Primary endpoint was first-pass bidirectional isthmus block (BIB). Study 2: lesion geometries created by each ablation strategy were compared using an ex-vivo model. Results: Study 1: TF-HPSD ablation strategy demonstrated a higher success rate of first-pass BIB than MPLD protocol (TC-MPLD, 58%; TF-MPLD, 48%; TF-HPSD, 94%, p < 0.001), without any complications. TF-HPSD group was associated with shorter total procedure and RF application times, as well as fewer ablation points and gaps, compared to the MPLD groups. Study 2: TF-HPSD created greater lesion surface length, width, and area than MPLD strategies. Conclusion: HPSD CTI-Abl performed by EP trainees using TactiFlex SE catheter demonstrated a higher first-pass BIB rate, shorter total procedure and RF application times, and fewer ablation points and gaps compared to the conventional method, without increasing complication rates.
AB - Introduction: The suitability of high-power short-duration (HPSD) cavo-tricuspid isthmus ablation (CTI-Abl) for electrophysiology (EP) trainees, as well as the underlying mechanisms of its efficacy, remain unknown. The aim of this study was to clarify the efficacy and safety of HPSD CTI-Abl performed by EP trainees and assess lesion characteristics between HPSD and moderate-power long duration (MPLD) ablations. Methods: Study 1: CTI-Abl was performed by first- to fourth-year EP trainees in consecutive 113 patients (67 ± 11 years, 27.2% female). Study cohort was historically divided into three groups: MPLD (30–35 W for up to 30 s) using TactiCath (TC-MPLD, N = 38) and MPLD and HPSD (50 W for 12 s) using TactiFlex (TF-MPLD, N = 23; TF-HPSD, N = 52). Primary endpoint was first-pass bidirectional isthmus block (BIB). Study 2: lesion geometries created by each ablation strategy were compared using an ex-vivo model. Results: Study 1: TF-HPSD ablation strategy demonstrated a higher success rate of first-pass BIB than MPLD protocol (TC-MPLD, 58%; TF-MPLD, 48%; TF-HPSD, 94%, p < 0.001), without any complications. TF-HPSD group was associated with shorter total procedure and RF application times, as well as fewer ablation points and gaps, compared to the MPLD groups. Study 2: TF-HPSD created greater lesion surface length, width, and area than MPLD strategies. Conclusion: HPSD CTI-Abl performed by EP trainees using TactiFlex SE catheter demonstrated a higher first-pass BIB rate, shorter total procedure and RF application times, and fewer ablation points and gaps compared to the conventional method, without increasing complication rates.
KW - ablation catheter
KW - atrial flutter
KW - catheter ablation
KW - cavo-tricuspid isthmus
KW - high-power short-duration
UR - http://www.scopus.com/inward/record.url?scp=85211489981&partnerID=8YFLogxK
U2 - 10.1111/jce.16516
DO - 10.1111/jce.16516
M3 - Article
AN - SCOPUS:85211489981
SN - 1045-3873
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
ER -