DOI: 10.1161/circ.148.suppl_1.13239 ISSN: 0009-7322

Abstract 13239: Atrial Fibrillation Ablation With High-Power Short-Duration Setting Reduces Change in Periprocedural Thrombotic Marker and Suppresses the Onset of Silent Stroke

Masashi Kamioka, Takafumi Okuyama, Tomonori Watanabe, Hiroaki Watanabe, Hisaki Makimoto, Ayako Yokota, Takahiro Komori, Tomoyuki Kabutoya, Yasushi Imai, Kazuomi Kario
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Background: Atrial fibrillation (AF) ablation with high-power short duration (HP-SD) setting has been widely recognized to decrease the procedure time and to improve the ablation outcome.

Hypothesis: We hypothesized that AF ablation with HP-SD setting can minimize the change in periprocedural thrombotic markers and the risk of silent stroke (SS).

Aims: The aim of the present study is to investigate the impact of HP-SD setting ablation for AF on thrombotic markers and SS.

Methods: We enrolled 101 AF patients: HP-SD group (n =67) using 50W; and Conventional ablation group (n = 34) using 30 to 40W. D-dimer, thrombin antithrombin complex (TAT) and total plasminogen activator inhibitor-1 (tPAI-1) were analyzed pre, post and 1 day after procedure. Magnetic resonance imaging was performed 1 day after procedure.

Results: Left atrial (LA) dwelling time was significantly shorter in HP-SD group (P<0.05). In Conventional ablation group, the D-dimer and tPAI-1 levels continued to increase until 1 day after, while the TAT peaked after the ablation. On the other hand, the range of the variation of these thrombotic markers in HP-SD group was smaller ( Figure 1 ). SS occurred more frequently in Conventional ablation group than in HP-SD group (26% vs 4%, P<0.05). In logistic regression analysis, HP-SD setting and TAT difference (post - pre-procedure) remained independent predictor for SS (Odds ratio: 0.141 and 5.838, P<0.05, respectively).

Conclusion: HP-SD setting was associated with the shorter LA dwelling time and the smaller thrombotic markers change than conventional ablation, which could contribute to the lower prevalence of SS.

More from our Archive