Heeger Christian-Hendrik, Almorad Alexandre, Scherr Daniel, Szegedi Nándor, Baran Jakub, Duytschaever Mattias, Gupta Dhiraj, Linz Dominik, Lyan Evgeny, Leventopoulos Georgios, Popescu Sorin Stefan, Rauber Martin, Kollias Georgios, Niedzwiedz Michał, Sarkozy Andrea, Badoz Marc, Sohns Christian, Ginks Matthew R, Pürerfellner Helmut, Tilz Roland R
Department of Rhythmology; Cardiology and Internal medicine, Asklepios Klinik Hamburg Altona, Hamburg, Germany.
University Heart Center Lübeck, Department of Rhythmology, University Hospital Schleswig-Holstein, Germany.
Europace. 2024 Nov 7. doi: 10.1093/europace/euae284.
Temperature-controlled high-power short-duration (HPSD) radiofrequency catheter ablation for pulmonary vein isolation (PVI) utilizing a novel ablation catheter (QDOT Micro) with real-time assessment of catheter tip temperature aims for safer, more effective and faster procedures.
The peQasus study is a large European multicenter study set up to assess safety, acute efficacy and outcomes of temperature-controlled HPSD based PVI. The primary endpoints were safety, efficacy and 12-months freedom from atrial tachyarrhythmias. Additionally, two strategies namely very HPSD (90W for 4 seconds) only and a hybrid approach (HPSD with maximum of 50W and vHPSD) were compared.
A total of 1,023 AF patients in 15 centers from 9 European countries received PVI with the QDOT. Complete PVI was successfully achieved in all patients. In 699/1023 (68.3%) the vHPSD only approach (vHPSD group) and in 324/(31.7%) patients the hybrid approach (hybrid group) was utilized. The mean procedure duration was 98.4±37.4 min (vHPSD: 88.2±34.9min, hybrid: 117.4±32.7min, p<0.001). The first pass isolation rate of all PVs was 64% (vHPSD: 62.6%, hybrid: 67.1%, p=0.187). Severe adverse events were observed in 1.7% (vHPSD: 1.6%, hybrid: 1.9%, p=0.746). 12-month arrhythmia-recurrence free survival was 77.1% (vHPSD: 76.8%, hybrid: 77.8%, p=0.241).
In this large multicentre study temperature-controlled HPSD and vHPSD ablation via a novel ablation catheter provides safe and effective PVI with a relatively short procedure duration. Despite a shorter procedure time no differences in terms of safety and freedom from arrhythmia-recurrence were found irrespective of utilizing vHPSD or the hybrid approach.
采用一种新型消融导管（QDOT Micro）进行温度控制的高功率短程（HPSD）射频导管消融术以实现肺静脉隔离（PVI），该导管可实时评估导管尖端温度，旨在实现更安全、更有效且更快的手术过程。
peQasus研究是一项大型欧洲多中心研究，旨在评估基于温度控制的HPSD的PVI的安全性、急性疗效和结果。主要终点为安全性、疗效以及12个月无房性快速心律失常。此外，还比较了两种策略，即仅采用极HPSD（90W持续4秒）和混合方法（最大50W的HPSD与极HPSD）。
来自9个欧洲国家15个中心的1023例房颤患者接受了使用QDOT导管的PVI。所有患者均成功实现了完全PVI。699/1023（68.3%）例患者采用仅极HPSD方法（极HPSD组），324/（31.7%）例患者采用混合方法（混合组）。平均手术时长为98.4±37.4分钟（极HPSD：88.2±34.9分钟，混合：117.4±32.7分钟，p<0.001）。所有肺静脉的首次隔离率为64%（极HPSD：62.6%，混合：67.1%，p=0.187）。观察到严重不良事件的发生率为1.7%（极HPSD：1.6%，混合：1.9%，p=0.746）。12个月无心律失常复发生存率为77.1%（极HPSD：76.8%，混合：77.8%，p=0.241）。
在这项大型多中心研究中，通过新型消融导管进行温度控制的HPSD和极HPSD消融术可提供安全有效的PVI，且手术时长相对较短。尽管手术时间较短，但无论采用极HPSD还是混合方法，在安全性和无心律失常复发方面均未发现差异。
