Can lesion parameters predict effective pulmonary vein isolation in very-high-power short-duration radiofrequency ablation?

Abstract Background Pulmonary vein isolation (PVI) is the cornerstone treatment for patients with atrial fibrillation (AF) refractory to medical therapy. Recent advancements have led development of contact-force (CF) sensing very-high-power short-duration (vHPSD) radiofrequency (RF) ablation (90W/4 seconds). Previous RF utilized Ablation Index (AI) as a marker lesion quality guide operator which not in QMODE+ and thus, there limited information on effective formation. In this study, we evaluated correlation between various parameters identify relationships potential surrogate markers Moreover, studied relationship different anatomical locations these gain further insight. Methods 50 consecutive AF (33 males, age 62.0±1.31 years, 66% paroxysmal AF) underwent first time PVI using QMODE+. All wide antral circumferential (WACA) lesions (n=5022) were analyzed force-time integral (FTI), impedance drop, average CF, maximum temperature attained location. The regions assessed across both left right WACA posterior-superior (region 1–2), posterior-inferior 3–4), anterior-inferior 5–6), anterior-superior 7–8) pulmonary carina 9). veins (PVs) checked pacing maneuvers examine gaps adenosine acute reconnection post-ablation. Results was successful all while pass observed 26 (52%). A total 5022 performed 2461 2561 respectively. CF exhibited positive drop (p<0.0001) displaying negative FTI (Figure 1). PV 9) had smallest lowest 2). highest number or (12 out 24 patients) seen region (p<0.0001). Conclusion This study that has investigated characteristics vHPSD at atrium. positively correlated but negatively FTI. Furthermore, demonstrates lower may potentially explain greater prevalence reconnections. provides detailed insight into region, contact force, will facilitate optimization Funding Acknowledgement Type funding sources: None.