Multicenter prospective comparison of conventional and high-power short duration radiofrequency application for pulmonary vein isolation: the high-power short-duration radiofrequency application for faster and safer pulmonary vein ablation (POWER FAST III) trial

Multicenter prospective comparison of conventional and high-power short duration radiofrequency application for pulmonary vein isolation: the high-power short-duration radiofrequency application for faster and safer pulmonary vein ablation (POWER FAST III) trial

Background Electrical isolation of pulmonary veins (PV) with high-power short-duration (HPSD) radiofrequency application (RFa) may reduce the duration of atrial fibrillation (AF) ablation, without compromising the procedural efficacy and safety in comparison with the conventional approach. This hypo...

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Published in:Journal of interventional cardiac electrophysiology Vol. 66; no. 8; pp. 1889 - 1899
Main Authors: Castrejón-Castrejón, Sergio, Martínez Cossiani, Marcel, Jáuregui-Abularach, Miguel, Basterra Sola, Nuria, Ibáñez Criado, José Luis, Osca Asensi, Joaquín, Roca Luque, Ivo, Moya Mitjans, Angel, Quesada Dorador, Aurelio, Hidalgo Olivares, Víctor Manuel, Pérez Castellano, Nicasio, Fernández Gómez, Juan Manuel, Macías-Ruiz, María Rosa, Bochard Villanueva, Bruno, Gonzalo Bada, Nerea, Fernández Prieto, Andrés, Guido López, Leonardo Elías, Martínez Maldonado, María Eugenia, Merino, Daniel, Escobar Cervantes, Carlos, Merino, José Luis
Format: Journal Article
Language:English
Published: New York Springer US 01-11-2023
Springer Nature B.V
Subjects:
Ablation
Arrhythmia
Cardiology
Clinical trials
Effectiveness
Lesions
Lungs
Magnetic resonance imaging
Medicine
Medicine & Public Health
Observational studies
Radio frequency
Safety
Veins
High-power short duration
Radiofrequency
Ablation
Atrial fibrillation
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Summary:Background Electrical isolation of pulmonary veins (PV) with high-power short-duration (HPSD) radiofrequency application (RFa) may reduce the duration of atrial fibrillation (AF) ablation, without compromising the procedural efficacy and safety in comparison with the conventional approach. This hypothesis has been generated in several observational studies; the POWER FAST III will test it in a randomized multicenter clinical trial. Methods It is a multicenter randomized, open-label and non-inferiority clinical trial with two parallel groups. AF ablation using 70 W and 9–10 s RFa is compared with the conventional technique using 25–40 W RFa guided by numerical lesion indexes. The main efficacy objective is the incidence of atrial arrhythmia recurrences electrocardiographically documented during 1-year follow-up. The main safety objective is the incidence of endoscopically detected esophageal thermal lesions (EDEL). This trial includes a substudy of incidence of asymptomatic cerebral lesions detected by magnetic resonance imaging (MRI) after ablation . Results A randomized clinical trial compares for the first time high-power short-duration and conventional ablation in order to obtain data about the efficacy and safety of the high-power technique in an adequate methodological context. Conclusions The results of the POWER FAST III could support the use of the high-power short-duration ablation in clinical practice. Registration : ClinicalTrials.gov: NTC04153747. Graphical Abstract
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ISSN:1572-8595
1383-875X
1572-8595
DOI:10.1007/s10840-023-01509-9