EFFICACY AND SAFETY OF HIGH-POWER SHORT-DURATION RADIOFREQUENCY ABLATION FOR ATRIAL FIBRILLATION

Lê Uyên Phương Trần1, , Ngọc Dũng Kiều1, Cao Đạt Trần1, Thái Duy Võ1, Quốc Khánh Trương1, Tri Thức Nguyễn2
1 Bệnh viện Chợ Rẫy
2 Bộ Y Tế

Main Article Content

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia associated with increased risks of stroke and heart failure. Radiofrequency ablation is an effective treatment method, with the high-power short-duration (HPSD) technique gaining attention due to its ability to create more homogeneous lesions and shorten procedure time.


Objective: To evaluate the preliminary efficacy and safety of HPSD ablation for atrial fibrillation at Cho Ray Hospital.


Methods: Retrospective cohort study.


Results: A total of 37 patients were enrolled; 68.4% were male, with a mean age of 54.0 ± 12.4 years. Paroxysmal AF accounted for 56.7% of cases. Complete isolation of all four pulmonary veins and restoration of sinus rhythm were achieved in all patients (100%). The median procedure time was 160 minutes (interquartile range: 142–186), with a pulmonary vein isolation time of 83 minutes (60–112) and a mean fluoroscopy time of 11.5 ± 4.6 minutes. Additional carina ablation was required in 37.8% of patients to achieve complete conduction block. Acute complications were infrequent, with no cases of esophageal injury, stroke, or procedural mortality.


Conclusion: High-power short-duration ablation for atrial fibrillation is an effective and safe method that helps optimize procedural workflow and reduce complications.

Article Details

References

1. Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights. Circulation research. 2020;127(1):4-20. Epub 2020/07/28. doi: 10.1161/circresaha.120.316340. PubMed PMID: 32716709; PubMed Central PMCID: PMCPMC7577553.
2. Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns H, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). European heart journal. 2024;45(36):3314-414. Epub 2024/08/31. doi: 10.1093/eurheartj/ehae176. PubMed PMID: 39210723.
3. Tzeis S, Gerstenfeld EP, Kalman J, Saad EB, Sepehri Shamloo A, Andrade JG, et al. 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace : European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2024;26(4). Epub 2024/04/08. doi: 10.1093/europace/euae043. PubMed PMID: 38587017; PubMed Central PMCID: PMCPMC11000153.
4. Sultan A, Kreutzer S, Wörmann J, Lüker J, Ackmann J, Schipper J-H, et al. HIgh Power short duration radiofrequency ablation or cryoballoon ablation for paroxysmal Atrial Fibrillation (HIPAF trial). EP Europace. 2025;27(5). doi: 10.1093/europace/euaf066.
5. Chieng D, Segan L, Sugumar H, Al-Kaisey A, Hawson J, Moore BM, et al. Higher power short duration vs. lower power longer duration posterior wall ablation for atrial fibrillation and oesophageal injury outcomes: a prospective multi-centre randomized controlled study (Hi-Lo HEAT trial). EP Europace. 2022;25(2):417-24. doi: 10.1093/europace/euac190 %J EP Europace.
6. Phạm TL, Ngô TN. Bước đầu đánh giá tính an toàn và hiệu quả của catheter cảm biến lực trong triệt đốt rung nhĩ tại viện tim mạch – bệnh viện bạch mai. Tạp chí Y học Việt Nam. 2025;555(2). doi: 10.51298/vmj.v555i2.16021.
7. Lee Adam C, Voskoboinik A, Cheung Christopher C, Yogi S, Tseng Zian H, Moss Joshua D, et al. A Randomized Trial of High vs Standard Power Radiofrequency Ablation for Pulmonary Vein Isolation. JACC: Clinical Electrophysiology. 2023;9(7_Part_2):1038-47. doi: 10.1016/j.jacep.2022.12.020.