High-power short-duration ablation of the atrioventricular node

Abstract

Abstract Introduction There are limited studies that compare different radiofrequency ablation catheters in atrioventricular node (AVN) ablation. Our study compared the effectiveness of several radiofrequency ablation catheters in AVN ablation. Methods We identified patients who underwent AVN ablation at our institution. Data related to patients and procedures were collected through retrospective chart review. The radiofrequency catheters compared were plain non-irrigated, externally irrigated (EI), and contact force sensing in two different settings: low-power long duration (LPLD) and high-power short duration (HPSD). We compared the different catheters in terms of success rate using logistic regression and lesion time using linear regression. Results We identified 66 patients who underwent AVN ablation, out of which 31 were female (47%). The patients were elderly, with a mean age of 73.27 years. The indications were resistant atrial fibrillation in 74%, atrial flutter in 18%, and other atrial tachycardias in 8% of patients. Types of catheters used were plain non-irrigated in 48%, EI in 2%, LPLD in 16%, and HPSD in 34% of patients. All ablation procedures were successful with no immediate post-procedure complications. Regarding lesion time, HPSD was significantly shorter compared to plain catheters by 403.42s[-631.67, -175.17] as shown in table 1. Conclusions While plain catheter, LPLD, and HPSD were equally safe and effective, HPSD catheter had significantly shorter lesion time and thus procedure time.