Vassallo Fabricio, Cunha Christiano, Corsino Lucas, Serpa Eduardo, Simões Aloyr, Hespanhol Dalton, Lovatto Carlos Volponi, Gasparini Dalbian, Barbosa Luiz Fernando, Schmidt Andre
Hospital Santa Rita de Cássia, Vitória, ES - Brasil.
Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória Faculdade de Medicina - Arritmias Cardíacas, Vitória, ES - Brasil.
Arq Bras Cardiol. 2024 Nov;121(12):e20230837. doi: 10.36660/abc.20230837.
Point-by-point ablation with a high-power short-duration (HPSD) technique in atrial fibrillation (AF) ablation is used worldwide. Little data is available with the HPSD and dragging technique (DT).
To perform a multivariate analysis of clinical and procedural predictors of success and recurrence in HPSD with DT.
214 patients in the first AF ablation in sinus rhythm were prospectively enrolled. DT with radiofrequency power of 50 W and contact force (CF) of 10-20 g and 5-10 g at a flow rate of 40 mL/min were applied on the anterior and posterior walls, respectively. Statistical significance was defined as p < 0.05.
143 (66.8%) males, paroxysmal AF (PAF) in 124 (57.9%), with 61.1±12.3 years and followed for 32.8±13.2 months. After 90 days, AF occurred in 43 (20.1%) patients, 19 (15.3%) from PAF, and 24 (26.7%) in persistent AF (PersAF). Multivariate analysis indicated as clinical predictors of recurrence: age ≥ 65 years (p=0.006); obesity [body mass index > 30 (p=0.009)]; CHA2DS2VASC score ≥ 3 (p=0.003); and PersAF (p=0.045). The procedural predictor of recurrence was a heart rate increase < 10% (p=0.006). Predictors of success were an increase in heart rate ≥ 30% (p=0.04) and < 60 min in left atrium time (LAT) (p=0.007).
AF ablation with DT and HPSD clinical and procedural predictors of recurrence were ≥ 65 years, obesity, a CHA2DS2VASC ≥ 3, PersAF, and a heart rate increase of < 10% after ablation. Success predictors were an increase of ≥ 30% in heart rate and low LAT (< 60 min).
心房颤动（AF）消融术中的高功率短持续时间（HPSD）逐点消融技术在全球范围内被广泛应用。关于HPSD和拖曳技术（DT）的数据较少。
对采用DT的HPSD消融成功及复发的临床和手术预测因素进行多变量分析。
前瞻性纳入214例首次进行窦性心律AF消融的患者。分别在前后壁应用射频功率为50W、接触力（CF）在前壁为10 - 20g、后壁为5 - 10g且流速为40mL/min的DT。统计学显著性定义为p < 0.05。
143例（66.8%）为男性，124例（57.9%）为阵发性AF（PAF），年龄61.1±12.3岁，随访32.8±13.2个月。90天后，43例（20.1%）患者发生AF，其中PAF患者19例（15.3%），持续性AF（PersAF）患者24例（26.7%）。多变量分析表明复发的临床预测因素为：年龄≥65岁（p = 0.006）；肥胖[体重指数>30（p = 0.
