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

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.