TY - JOUR
T1 - Shortened radiofrequency delivery time to optimize efficiency and safety of pulmonary vein isolation with the radiofrequency balloon
T2 - insights from the COLLABORATE registry
AU - Almorad, Alexandre
AU - Della Rocca, Domenico Giovanni
AU - Monte, Alvise Del
AU - Vijgen, Johan
AU - Koopman, Pieter
AU - Worck, René
AU - Johannessen, Arne
AU - Lepièce, Caroline
AU - de Ravenstein, Antoine de Meester
AU - Strisciuglio, Teresa
AU - Poggi, Sara
AU - Stabile, Giuseppe
AU - Greca, Carmelo La
AU - Kheir, Joseph Antoine
AU - Jesel-Morel, Laurence
AU - Haddad, Milad El
AU - Hossein, Amin
AU - Audiat, Charles
AU - Scacciavillani, Roberto
AU - Pannone, Luigi
AU - de Asmundis, Carlo
AU - Chierchia, Gian Battista
AU - Collaborate Registry
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Aims Previous clinical studies on pulmonary vein isolation (PVI) with a radiofrequency balloon (RFB) reported safe and effective procedures using conventional ablation settings with 20/60 s RF delivery via posterior/anterior (PST/ANT) electrodes. The latest evidence suggests that reducing the application time to 15 s (s) on the posterior wall when facing the oesophageal region is as effective as applying 20 s. To prospectively assess whether reducing RF time on PST/ANT segments to 15/ 45 s can ensure sufficient quality of lesion metrics and compare the new shortened ablation settings with the conventional one in terms of safety, and effectiveness at 1-year. Methods and results A total of 641 patients from seven European centres were enrolled in a collaborative registry, with 374 in the conventional RF delivery group and 267 in the shortened RF delivery group. Procedural outcomes, lesion metrics, and safety profiles were assessed and compared between the groups. Freedom of any atrial tachycarrythmias at one year was 85.4% and 88.2% in the SHRT and CONV groups, respectively. The shortened RF delivery strategy was associated with significantly shorter procedure times (median 63.5 vs. 96.5 min, P < 0.001) and shortened fluoroscopy exposure (median 10.0 vs. 14.0 min, P < 0.001) compared to conventional delivery. Efficacy metrics, including first-pass isolation rates and time to isolation, were comparable between groups. Shortened RF delivery was associated with a lower incidence of procedural complications (1.4% vs. 5.3%, P = 0.04) and optimized thermal characteristics. Conclusion Analyses from the COLLABORATE registry demonstrate that shortening RF energy delivery times to 15/45 s (PST/ANT) during PVI with the RFB resulted in comparable freedom from recurrent atrial tachyarrhythmia compared to conventional delivery times with comparable efficiency and safety.
AB - Aims Previous clinical studies on pulmonary vein isolation (PVI) with a radiofrequency balloon (RFB) reported safe and effective procedures using conventional ablation settings with 20/60 s RF delivery via posterior/anterior (PST/ANT) electrodes. The latest evidence suggests that reducing the application time to 15 s (s) on the posterior wall when facing the oesophageal region is as effective as applying 20 s. To prospectively assess whether reducing RF time on PST/ANT segments to 15/ 45 s can ensure sufficient quality of lesion metrics and compare the new shortened ablation settings with the conventional one in terms of safety, and effectiveness at 1-year. Methods and results A total of 641 patients from seven European centres were enrolled in a collaborative registry, with 374 in the conventional RF delivery group and 267 in the shortened RF delivery group. Procedural outcomes, lesion metrics, and safety profiles were assessed and compared between the groups. Freedom of any atrial tachycarrythmias at one year was 85.4% and 88.2% in the SHRT and CONV groups, respectively. The shortened RF delivery strategy was associated with significantly shorter procedure times (median 63.5 vs. 96.5 min, P < 0.001) and shortened fluoroscopy exposure (median 10.0 vs. 14.0 min, P < 0.001) compared to conventional delivery. Efficacy metrics, including first-pass isolation rates and time to isolation, were comparable between groups. Shortened RF delivery was associated with a lower incidence of procedural complications (1.4% vs. 5.3%, P = 0.04) and optimized thermal characteristics. Conclusion Analyses from the COLLABORATE registry demonstrate that shortening RF energy delivery times to 15/45 s (PST/ANT) during PVI with the RFB resulted in comparable freedom from recurrent atrial tachyarrhythmia compared to conventional delivery times with comparable efficiency and safety.
KW - Atrial fibrillation
KW - Oesophageal temperature
KW - Pulmonary vein isolation
KW - Radiofrequency balloon
KW - Shortened RF delivery
UR - http://www.scopus.com/inward/record.url?scp=85205084417&partnerID=8YFLogxK
U2 - 10.1093/europace/euae227
DO - 10.1093/europace/euae227
M3 - Journal article
C2 - 39228338
AN - SCOPUS:85205084417
SN - 1099-5129
VL - 26
JO - Europace
JF - Europace
IS - 9
M1 - euae227
ER -