Ming-Jen Kuo MD, Shih-Lin Chang MD, PhD, Jin-Long Huang MD, PhD, Yenn-Jiang Lin MD, PhD, Yu-Cheng Hsieh MD, PhD, Li-Wei Lo MD, PhD, Yu-Feng Hu MD, PhD, Fa-Po Chung MD, PhD, Cheng-Hung Li MD, PhD, Chin-Yu Lin MD, PhD, Ting-Yung Chang MD, Ling Kuo MD, Cheng-I Wu MD, Chih-Min Liu MD, Shin-Huei Liu MD, Yu-Shan Huang MD, Shih-Ann Chen MD
{"title":"阵发性心房颤动患者病灶大小指数引导下高功率消融高密度定位肺静脉隔离的远期疗效","authors":"Ming-Jen Kuo MD, Shih-Lin Chang MD, PhD, Jin-Long Huang MD, PhD, Yenn-Jiang Lin MD, PhD, Yu-Cheng Hsieh MD, PhD, Li-Wei Lo MD, PhD, Yu-Feng Hu MD, PhD, Fa-Po Chung MD, PhD, Cheng-Hung Li MD, PhD, Chin-Yu Lin MD, PhD, Ting-Yung Chang MD, Ling Kuo MD, Cheng-I Wu MD, Chih-Min Liu MD, Shin-Huei Liu MD, Yu-Shan Huang MD, Shih-Ann Chen MD","doi":"10.1002/joa3.70127","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Data on the long-term outcomes and procedural details of the lesion size index-guided high-power ablation strategy (HP-LSI) are limited.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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; <i>p</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 4","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70127","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Ming-Jen Kuo MD, Shih-Lin Chang MD, PhD, Jin-Long Huang MD, PhD, Yenn-Jiang Lin MD, PhD, Yu-Cheng Hsieh MD, PhD, Li-Wei Lo MD, PhD, Yu-Feng Hu MD, PhD, Fa-Po Chung MD, PhD, Cheng-Hung Li MD, PhD, Chin-Yu Lin MD, PhD, Ting-Yung Chang MD, Ling Kuo MD, Cheng-I Wu MD, Chih-Min Liu MD, Shin-Huei Liu MD, Yu-Shan Huang MD, Shih-Ann Chen MD\",\"doi\":\"10.1002/joa3.70127\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Data on the long-term outcomes and procedural details of the lesion size index-guided high-power ablation strategy (HP-LSI) are limited.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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; <i>p</i> = 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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15174,\"journal\":{\"name\":\"Journal of Arrhythmia\",\"volume\":\"41 4\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70127\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Arrhythmia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70127\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70127","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
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
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.
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