Long‐term outcome of lesion size index‐guided high‐power ablation with high‐density mapping for pulmonary vein isolation in patients with paroxysmal atrial fibrillation

Abstract Introduction Data on the long‐term outcomes and procedural details of the lesion size index‐guided high‐power ablation strategy (HP‐LSI) are limited. Methods Eighty patients were retrospectively assigned to the high‐power with time‐restricted ablation strategy (fixed at 10 s per lesion), wh...

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Main Authors: Ming‐Jen Kuo, Shih‐Lin Chang, Jin‐Long Huang, Yenn‐Jiang Lin, Yu‐Cheng Hsieh, Li‐Wei Lo, Yu‐Feng Hu, Fa‐Po Chung, Cheng‐Hung Li, Chin‐Yu Lin, Ting‐Yung Chang, Ling Kuo, Cheng‐I Wu, Chih‐Min Liu, Shin‐Huei Liu, Yu‐Shan Huang, Shih‐Ann Chen
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Journal of Arrhythmia
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Online Access:https://doi.org/10.1002/joa3.70127
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Summary:Abstract Introduction Data on the long‐term outcomes and procedural details of the lesion size index‐guided high‐power ablation strategy (HP‐LSI) are limited. Methods Eighty patients were retrospectively assigned to the high‐power with time‐restricted ablation strategy (fixed at 10 s per lesion), while 67 patients were assigned to the high power LSI‐guided strategy (anterior wall LSI at least 5.0, posterior wall LSI 4.5). The 1‐year AF recurrence rate and various procedural details were compared between the two groups. Results The HP‐LSI group exhibited a significantly lower rate of AF recurrence (14.9% vs. 32.5%; HR: 0.36, 95% CI: 0.16–0.83; p = 0.016). Additionally, fewer gaps were identified in various PV segments in the HP‐LSI group following the initial pass of PV circumferential ablation. The radiofrequency time, LA dwelling time, and skin‐to‐skin time were shorter, and the first‐pass isolation rates for both pulmonary veins were higher in the HP‐LSI group. Conclusion The HP‐LSI ablation strategy is associated with a significantly lower AF recurrence rate and improved procedural efficiency, suggesting its potential as a preferred strategy for PVI.
ISSN:1880-4276
1883-2148