High efficiency single-catheter workflow for radiofrequency atrial fibrillation ablation in the QDOT catheter era
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: High-power short-duration (HPSD) ablation may improve the consistency and efficiency of pulmonary vein isolation (PVI). The novel QDOT Micro™ catheter (Biosense Webster, Inc.) with temperature feedback and microelectrodes aims to enhance PVI efficiency and safety. This study wants to evaluate the feasibility, safety, and efficiency of a standardized single-catheter workflow for PVI using QDOT (Q-FLOW).
METHODS: The Q-FLOW includes single transeptal access, radiofrequency encircling of the PVs using a power of 50 W in a temperature/flow-controlled mode, and validation of the circles with microelectrodes. A 1:1 propensity-matched cohort of patients treated with conventional power-controlled ablation using a circular mapping catheter (CMC-FLOW) was used to compare procedural and clinical outcomes.
RESULTS: A total of 150 consecutive atrial fibrillation patients (paroxysmal 67%, persistent 33%) were included. First-pass isolation rate was 86%. Procedural time, X-ray time, and dose were significantly lower for the Q-FLOW vs the CMC-FLOW (67.2 ± 17.9 vs 88.3 ± 19.2 min, P < 0.001; 3.0 ± 1.9 vs 5.0 ± 2.4 min, P < 0.001; 4.3 ± 1.9 vs 6.4 ± 2.3 Gycm2, P < 0.001). Complications were numerically but not significantly lower in the Q-FLOW group (2 [1.3%] vs 7 [4.7%], P = 0.091). There was no difference in arrhythmia recurrence at 12 months (atrial arrhythmia-free survival rate, 87.5% vs 84.4%, P = 0.565).
CONCLUSION: A streamlined single-catheter workflow for PVI using QDOT was feasible and safe, resulting in a high rate of first-pass isolation and a low complication rate. The Q-FLOW further improved the efficiency of PVI compared to the standard CMC-FLOW, without difference in the 12-month outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing - (2023) vom: 14. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Valeriano, Chiara [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial fibrillation (AF) |
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| Anmerkungen: |
Date Revised 13.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s10840-023-01709-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a High efficiency single-catheter workflow for radiofrequency atrial fibrillation ablation in the QDOT catheter era |
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| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND: High-power short-duration (HPSD) ablation may improve the consistency and efficiency of pulmonary vein isolation (PVI). The novel QDOT Micro™ catheter (Biosense Webster, Inc.) with temperature feedback and microelectrodes aims to enhance PVI efficiency and safety. This study wants to evaluate the feasibility, safety, and efficiency of a standardized single-catheter workflow for PVI using QDOT (Q-FLOW) | ||
| 520 | |a METHODS: The Q-FLOW includes single transeptal access, radiofrequency encircling of the PVs using a power of 50 W in a temperature/flow-controlled mode, and validation of the circles with microelectrodes. A 1:1 propensity-matched cohort of patients treated with conventional power-controlled ablation using a circular mapping catheter (CMC-FLOW) was used to compare procedural and clinical outcomes | ||
| 520 | |a RESULTS: A total of 150 consecutive atrial fibrillation patients (paroxysmal 67%, persistent 33%) were included. First-pass isolation rate was 86%. Procedural time, X-ray time, and dose were significantly lower for the Q-FLOW vs the CMC-FLOW (67.2 ± 17.9 vs 88.3 ± 19.2 min, P < 0.001; 3.0 ± 1.9 vs 5.0 ± 2.4 min, P < 0.001; 4.3 ± 1.9 vs 6.4 ± 2.3 Gycm2, P < 0.001). Complications were numerically but not significantly lower in the Q-FLOW group (2 [1.3%] vs 7 [4.7%], P = 0.091). There was no difference in arrhythmia recurrence at 12 months (atrial arrhythmia-free survival rate, 87.5% vs 84.4%, P = 0.565) | ||
| 520 | |a CONCLUSION: A streamlined single-catheter workflow for PVI using QDOT was feasible and safe, resulting in a high rate of first-pass isolation and a low complication rate. The Q-FLOW further improved the efficiency of PVI compared to the standard CMC-FLOW, without difference in the 12-month outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atrial fibrillation (AF) | |
| 650 | 4 | |a High-power short-duration (HPSD) | |
| 650 | 4 | |a Pulmonary vein isolation (PVI) | |
| 650 | 4 | |a QDOT Micro catheter | |
| 650 | 4 | |a Radiofrequency ablation (RF) | |
| 650 | 4 | |a Single-catheter workflow | |
| 700 | 1 | |a Buytaert, Dimitri |e verfasserin |4 aut | |
| 700 | 1 | |a Fabbricatore, Davide |e verfasserin |4 aut | |
| 700 | 1 | |a De Schouwer, Koen |e verfasserin |4 aut | |
| 700 | 1 | |a Addeo, Lucio |e verfasserin |4 aut | |
| 700 | 1 | |a De Braekeleer, Lisa |e verfasserin |4 aut | |
| 700 | 1 | |a Geelen, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a De Potter, Tom |e verfasserin |4 aut | |
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