High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis
Background: Data on atrial fibrillation (AF) ablation using high-power short-duration (HPSD) ablation in patients over 80 years are lacking. Objective: This study aimed to compare the safety and efficacy of paroxysmal and persistent AF ablation using an HPSD (60–90 W/4–8 sec) vs conventional ablatio...
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Elsevier
2025-08-01
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| Series: | Heart Rhythm O2 |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501825001680 |
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| author | Alex Tunsch Martinez, MD Raphael Spittler, MD Nico Erhard, MD Florian Englert, MD Jan Syväri, MD Hannah Krafft, MD Miruna Popa, MD Theresa Reiter, MD Dominic Dischl, MD Eva Koops, MD Marta Telishevska, MD Sarah Lengauer, MD Gabriele Hessling, MD Isabel Deisenhofer, MD, FHRS Fabian Bahlke, MD |
| author_facet | Alex Tunsch Martinez, MD Raphael Spittler, MD Nico Erhard, MD Florian Englert, MD Jan Syväri, MD Hannah Krafft, MD Miruna Popa, MD Theresa Reiter, MD Dominic Dischl, MD Eva Koops, MD Marta Telishevska, MD Sarah Lengauer, MD Gabriele Hessling, MD Isabel Deisenhofer, MD, FHRS Fabian Bahlke, MD |
| author_sort | Alex Tunsch Martinez, MD |
| collection | DOAJ |
| description | Background: Data on atrial fibrillation (AF) ablation using high-power short-duration (HPSD) ablation in patients over 80 years are lacking. Objective: This study aimed to compare the safety and efficacy of paroxysmal and persistent AF ablation using an HPSD (60–90 W/4–8 sec) vs conventional ablation (30–40 W/30 sec) in a propensity score-matched cohort of patients older than 80 years. Methods: Overall, 232 consecutive patients aged over 80 years undergoing AF ablation were included. Propensity score matching revealed 102 pairs for maximizing comparability. A post-ablation 42-day blanking period was applied. Major complications were defined as those requiring intervention or causing sequels within 30 days following catheter ablation. Results: Procedural duration (132.7 ± 45.7 vs 155.4 ± 59.7 min; P = .0062) and x-ray exposure (dose area product 248.9 ± 313.6 vs 544.9 ± 704.7 cGycm2; P = .0002) were significantly reduced in the HPSD group. Safety end points showed no significant differences (4/102 vs 7/102; P = .54). Freedom from any arrhythmia was not different between the groups including a follow-up of 22.5 ± 22.7 months (hazard ratio, 0.71; 95% confidence interval, 0.48–1.06 for the HPSD approach). After 1.52 ± 0.79 procedures, 80.4 % of all patients remained in sinus rhythm with a lower number of repeat procedures in the HPSD group (1.38 ± 0.65 vs 1.65 ± 0.90; P = .038). Conclusions: In very old patients (>80 years), AF ablation using an HPSD approach can be performed safely and effectively with a reduction of procedure duration, x-ray exposure, and fewer repeat ablations compared to a conventional approach. Long-term ablation results are promising with both approaches. |
| format | Article |
| id | doaj-art-dc1cc56ab70840529e02cc00bb6d0d00 |
| institution | Kabale University |
| issn | 2666-5018 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj-art-dc1cc56ab70840529e02cc00bb6d0d002025-08-24T05:14:45ZengElsevierHeart Rhythm O22666-50182025-08-01681139114610.1016/j.hroo.2025.05.018High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysisAlex Tunsch Martinez, MD0Raphael Spittler, MD1Nico Erhard, MD2Florian Englert, MD3Jan Syväri, MD4Hannah Krafft, MD5Miruna Popa, MD6Theresa Reiter, MD7Dominic Dischl, MD8Eva Koops, MD9Marta Telishevska, MD10Sarah Lengauer, MD11Gabriele Hessling, MD12Isabel Deisenhofer, MD, FHRS13Fabian Bahlke, MD14Department of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyCenter of Cardiology, Department of Cardiology II – Electrophysiology, University Medical Center Mainz, Mainz, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, GermanyDepartment of Electrophysiology, TUM University Hospital German Heart Center, Munich, Germany; Address reprint requests and correspondence: Dr Fabian Bahlke, Department of Electrophysiology, German Heart Center Munich, Lazarettstr. 36, 80636 Munich, Germany.Background: Data on atrial fibrillation (AF) ablation using high-power short-duration (HPSD) ablation in patients over 80 years are lacking. Objective: This study aimed to compare the safety and efficacy of paroxysmal and persistent AF ablation using an HPSD (60–90 W/4–8 sec) vs conventional ablation (30–40 W/30 sec) in a propensity score-matched cohort of patients older than 80 years. Methods: Overall, 232 consecutive patients aged over 80 years undergoing AF ablation were included. Propensity score matching revealed 102 pairs for maximizing comparability. A post-ablation 42-day blanking period was applied. Major complications were defined as those requiring intervention or causing sequels within 30 days following catheter ablation. Results: Procedural duration (132.7 ± 45.7 vs 155.4 ± 59.7 min; P = .0062) and x-ray exposure (dose area product 248.9 ± 313.6 vs 544.9 ± 704.7 cGycm2; P = .0002) were significantly reduced in the HPSD group. Safety end points showed no significant differences (4/102 vs 7/102; P = .54). Freedom from any arrhythmia was not different between the groups including a follow-up of 22.5 ± 22.7 months (hazard ratio, 0.71; 95% confidence interval, 0.48–1.06 for the HPSD approach). After 1.52 ± 0.79 procedures, 80.4 % of all patients remained in sinus rhythm with a lower number of repeat procedures in the HPSD group (1.38 ± 0.65 vs 1.65 ± 0.90; P = .038). Conclusions: In very old patients (>80 years), AF ablation using an HPSD approach can be performed safely and effectively with a reduction of procedure duration, x-ray exposure, and fewer repeat ablations compared to a conventional approach. Long-term ablation results are promising with both approaches.http://www.sciencedirect.com/science/article/pii/S2666501825001680Atrial fibrillationAblation of ElderlyCatheter ablationHigh-power short-duration ablationPropensity score matching |
| spellingShingle | Alex Tunsch Martinez, MD Raphael Spittler, MD Nico Erhard, MD Florian Englert, MD Jan Syväri, MD Hannah Krafft, MD Miruna Popa, MD Theresa Reiter, MD Dominic Dischl, MD Eva Koops, MD Marta Telishevska, MD Sarah Lengauer, MD Gabriele Hessling, MD Isabel Deisenhofer, MD, FHRS Fabian Bahlke, MD High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis Heart Rhythm O2 Atrial fibrillation Ablation of Elderly Catheter ablation High-power short-duration ablation Propensity score matching |
| title | High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis |
| title_full | High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis |
| title_fullStr | High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis |
| title_full_unstemmed | High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis |
| title_short | High-power short-duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age: A propensity-score matched cohort analysis |
| title_sort | high power short duration vs conventional radiofrequency ablation for atrial fibrillation in patients over 80 years of age a propensity score matched cohort analysis |
| topic | Atrial fibrillation Ablation of Elderly Catheter ablation High-power short-duration ablation Propensity score matching |
| url | http://www.sciencedirect.com/science/article/pii/S2666501825001680 |
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