A new criterium for optimal energy application in ultra-high-power short-duration ablation

Abstract Funding Acknowledgements Type of funding sources: None. Background Ultra-high-power short-duration (UHPSD) ablation with the novel QDOT™ catheter allows to maintain a target temperature by automatically adjusting flow and power during 4-second application 90 Watt. However, optimal contact-force for sufficient lesion generation is yet be determined. Methods This study comprised 41 patients symptomatic atrial fibrillation undergoing pulmonary vein isolation (PVI) QDot using UHPSD mode W 4 seconds. All applications circumferential PVI were analyzed. Suboptimal defined as either an impedance drop ≤5% or cumulative temperature-limited energy ≤330 W. Results A total 1904 (46.4 per patient) performed average contact force (aCF) 12.3±6.4 g mean maximum (maxTemp) 48.4±3.8 °C (ImpDrop) 10±3.2%. An ImpDrop occurred in 67 (3.5%) which was associated lower aCF (10.6±7 vs. 12.4±6.4 g; p=0.024) maxTemp (45.8±3.8 48.5±3.8 °C; p<0.001) compared >5%. observed 39 (2%) applications. Interestingly, low (≤330 W) characterized higher (21±9.6 12.1±6.2 p<0.001). Furthermore, significantly more often <5.6 >21.1 (10.2% vs 3.6%; p=0.004). Conclusion but also high (<6 >21g) are suboptimal Thus, require ’15-gram window’ achieve energy.