IMR Press / RCM / Volume 24 / Issue 12 / DOI: 10.31083/j.rcm2412363
Open Access Review
High-Power Short-Duration Ablation of Paroxysmal and Persistent Atrial Fibrillation
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1 Cardiac Arrhythmia Service, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
2 HCA Electrophysiology, Mercy Hospital, Miami, FL 33133, USA
*Correspondence: jeromero@bwh.harvard.edu (Jorge E. Romero)
C Hoyos and C Matos contributed equally to the manuscript as co-first authors.
§P Zei and JE Romero contributed equally to the manuscript as senior authors.
Rev. Cardiovasc. Med. 2023, 24(12), 363; https://doi.org/10.31083/j.rcm2412363
Submitted: 1 August 2023 | Revised: 29 August 2023 | Accepted: 1 September 2023 | Published: 25 December 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Catheter ablation has become a cornerstone in atrial fibrillation (AF) therapy, improving freedom from all-atrial arrhythmias, as well as outperforming antiarrhythmic drugs in alleviating AF-related symptoms, reducing hospitalizations, and enhancing quality of life. Nevertheless, the success rate of traditional radiofrequency ablation (RFA) methods remains less than ideal. To address these issues, refinement in RFA strategies has been developed to improve efficacy and laboratory efficiency during pulmonary vein isolation (PVI). High-power short-duration (HPSD) RFA has emerged as a safe strategy to reduce the time required to produce durable lesions. This article reviews critical aspects of HPSD ablation in the management of both paroxysmal and persistent AF, covering aspects such as effectiveness, safety, procedural intricacies, and the underlying biophysics.

Keywords
atrial fibrillation
pulmonary vein isolation
high-power short-duration
radiofrequency ablation
ablation techniques
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