Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
Temperature-guided high and very high-power short duration ablation for atrial fibrillation treatment: the peQasus multicentre study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Heeger Christian-Hendrik, Almorad Alexandre, Scherr Daniel, Szegedi Nándor, Seidl Sebastian, Baran Jakub, Duytschaever Mattias, Gupta Dhiraj, Linz Dominik, Lyan Evgeny, Rocca Domenico Della, Gellér László, Knecht Sebastien, Calvert Peter, Meilak Samuel, Leventopoulos Georgios, Popescu Sorin Stefan, Rauber Martin, Kollias Georgios, Niedzwiedz Michał, Sarkozy Andrea, Badoz Marc, Manninger-Wünscher Martin, Sciacca Vanessa, Sohns Christian, Ginks Matthew R, Pürerfellner Helmut, Tilz Roland R
Аннотация
AIMS: Temperature-controlled high-power short-duration (HPSD) radiofrequency catheter ablation for pulmonary vein isolation (PVI) utilizing a novel ablation catheter (QDOT Micro) with real-time assessment of catheter tip temperature aims for safer, more effective, and faster procedures.
METHODS AND RESULTS: The peQasus study is a large European multicentre study set up to assess safety, acute efficacy, and outcomes of temperature-controlled HPSD-based PVI. The primary endpoints were safety, efficacy, and 12-month freedom from atrial tachyarrhythmias. Additionally, two strategies namely very HPSD (90 W for 4 s) only and a hybrid approach (HPSD with maximum of 50 W and vHPSD) were compared. A total of 1023 AF patients in 15 centres from nine European countries received PVI with the QDOT. Complete PVI was successfully achieved in all patients. In 699/1023 (68.3%), the vHPSD-only approach (vHPSD group) and in 324/ (31.7%) patients, the hybrid approach (hybrid group) was utilized. The mean procedure duration was 98.4 ± 37.4 min (vHPSD: 88.2 ± 34.9 min, hybrid: 117.4 ± 32.7 min, P < 0.001). The first-pass isolation rate of all PVs was 64% (vHPSD: 62.6%, hybrid: 67.1%, P = 0.187). Severe adverse events were observed in 1.7% (vHPSD: 1.6%, hybrid: 1.9%, P = 0.746). Twelve-month arrhythmia-recurrence-free survival was 77.1% (vHPSD: 76.8%, hybrid: 77.8%, P = 0.241).
CONCLUSION: In this large multicentre study, temperature-controlled HPSD and vHPSD ablation via a novel ablation catheter provides safe and effective PVI with a relatively short procedure duration. Despite a shorter procedure time, no differences in terms of safety and freedom from arrhythmia recurrence were found irrespective of utilizing vHPSD or the hybrid approach.
METHODS AND RESULTS: The peQasus study is a large European multicentre study set up to assess safety, acute efficacy, and outcomes of temperature-controlled HPSD-based PVI. The primary endpoints were safety, efficacy, and 12-month freedom from atrial tachyarrhythmias. Additionally, two strategies namely very HPSD (90 W for 4 s) only and a hybrid approach (HPSD with maximum of 50 W and vHPSD) were compared. A total of 1023 AF patients in 15 centres from nine European countries received PVI with the QDOT. Complete PVI was successfully achieved in all patients. In 699/1023 (68.3%), the vHPSD-only approach (vHPSD group) and in 324/ (31.7%) patients, the hybrid approach (hybrid group) was utilized. The mean procedure duration was 98.4 ± 37.4 min (vHPSD: 88.2 ± 34.9 min, hybrid: 117.4 ± 32.7 min, P < 0.001). The first-pass isolation rate of all PVs was 64% (vHPSD: 62.6%, hybrid: 67.1%, P = 0.187). Severe adverse events were observed in 1.7% (vHPSD: 1.6%, hybrid: 1.9%, P = 0.746). Twelve-month arrhythmia-recurrence-free survival was 77.1% (vHPSD: 76.8%, hybrid: 77.8%, P = 0.241).
CONCLUSION: In this large multicentre study, temperature-controlled HPSD and vHPSD ablation via a novel ablation catheter provides safe and effective PVI with a relatively short procedure duration. Despite a shorter procedure time, no differences in terms of safety and freedom from arrhythmia recurrence were found irrespective of utilizing vHPSD or the hybrid approach.