Durable pulmonary vein isolation with optimized high‐power and very high‐power short‐duration temperature‐controlled ablation: A step‐by‐step guide.

Introduction: Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power‐controlled ablation catheters with conventional power ranges was the norm. Th...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 35; no. 5; pp. 886 - 895
Autores principales: De Potter, Tom J. R., De Becker, Benjamin, Duytschaever, Mattias
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell May2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2024
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.16217
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        atl: Durable pulmonary vein isolation with optimized high‐power and very high‐power short‐duration temperature‐controlled ablation: A step‐by‐step guide.
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        au:
          De Potter, Tom J. R.
          De Becker, Benjamin
          Duytschaever, Mattias
        affil: Cardiovascular Center, Division of Cardiology, Onze Lieve Vrouwziekenhuis Hospital, Aalst, Belgium.
      sug:
        subj:
          Atrial Fibrillation Physiopathology
          Pulmonary Veins Physiopathology
          Atrial Fibrillation Surgery
          Pulmonary Veins Surgery
          Catheter Ablation Methods
          Radiofrequency Ablation Methods
          Vascular Access Devices
          Time Factors
          Temperature
          Treatment Outcomes
          Human
          In Vivo Studies
          Action Potentials
          Workflow
          Heart Rate
          Equipment Design
          Biophysics
          Catheter Irrigation, Vascular
          Catheters, Vascular
          Funding Source
      ab: Introduction: Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power‐controlled ablation catheters with conventional power ranges was the norm. There has been increased adoption of a high‐power and very high‐power short‐duration ablation practice propelled by the availability of the temperature‐controlled radiofrequency QDOT MICRO catheter. Methods: There are fundamental differences in biophysics between very high‐ powered temperature guided ablation and conventional ablation strategy that may impact patient outcomes. The catheter's design and ablation modes offer flexibility in technique while accommodating the individual operator's clinical discretion and preference to deliver a durable, transmural, and contiguous lesion set. Results: Here, we provide recommendations for 3 different workflows using the QDOT MICRO catheter in a step‐by‐step manner for pulmonary vein isolation based on our cumulative experience as early adopters of the technology and the data available in the scientific literature. Conclusions: With standardization, temperature‐controlled ablation with the QDOT MICRO catheter provides operators the flexibility of implementing different ablation strategies to ensure durable contiguous pulmonary vein isolation depending on patient characteristics.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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