SPC365

Standard vs High Power in AF Ablation – Adding Efficiency to Efficacy: does it translates to real world in a medium-volume center?

Session: Sessão de Posters 54 - Da energia aos endpoints na FA
Speaker: Marco Cristo Tomaz

Congress: CPC 2026
Topic: C. Arrhythmias and Device Therapy
Theme: 05. Atrial Fibrillation
Subtheme: 05.4 Atrial Fibrillation - Treatment
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Marco Cristo Tomaz; David Campos; Patricia Bernardes; Catarina Pohle; Jeni Quintal; Ivo Palmeiro; José Farinha; Dinis Mesquita; Filipe Seixo; Leonor Parreira

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Catheter ablation using radiofrequency (RF) energy is an established therapy for atrial fibrillation (AF), yet procedural efficiency and radiation exposure remain key challenges in electrophysiology practice. Advances in technology aim to improve efficiency while reducing fluoroscopy use and total procedure time. Reducing radiation exposure is essential for patient and operator safety; similarly, improving time efficiency has become a priority for centers facing a growing procedural demand. Given these factors, evaluating whether newer RF catheter technologies <span style="color:black">do in fact enhance </span>procedural efficiency without compromising effectiveness is clinically relevant. This study compares AF ablation <span style="color:black">using standard power and duration versus high power and short duration ablation, focusing </span>on fluoroscopy exposure and total procedure time as indicators of workflow optimization.</span></span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">We conducted a retrospective, single-center study, including all consecutive patients who underwent RF catheter ablation for AF between January 2022 and December 2024. During this period, 2 contact-force sensing catheters &ndash; TactiFlex&reg; and TactiCath&reg; - were used according to operator preference.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">A total of 112 patients were included, comprising 46 women (41.1%) and 66 men (58.9%), with a median age of 66 years (58-72). The mean left atrial indexed volume was 44mL/m2 (35-63). Of these procedures, 81 patients underwent ablation with TactiFlex&reg; catheter, whereas 31 patients were treated with the TactiCath&reg; catheter. All patients underwent standard RF pulmonary vein isolation under 3D electroanatomic mapping guidance. Procedural parameters, including total procedure time and fluoroscopy exposure, were prospectively recorded in the institutional database.</span></span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">A total of 112 AF ablation procedures were analyzed. Because the distributions were non-normal, non-parametric testing was applied. TactiFlex&reg; was associated with significantly lower fluoroscopy/procedure time compared with TactiCath&reg; (median 45.6min vs 85.0min; U=372.0; Z=&ndash;5.75; p&lt;0.001) and lower radiation exposure (median 48.6</span></span><span style="font-size:9pt"><span style="font-family:Symbol">m</span></span><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Gy vs. 77.1</span></span><span style="font-size:9pt"><span style="font-family:Symbol">m</span></span><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">Gy; U=616.5; Z=&ndash;4.16; p&lt;0.001). <span style="color:black">During a follow up of 360 days, recurrence </span>rates differed significantly between catheter types, with TactiFlex&reg; demonstrating a lower recurrence rate (17.5% vs. 45.2%), confirmed by Pearson&rsquo;s chi-square test (&chi;&sup2;=9.06, p=0.003) and Fisher&rsquo;s exact test (p=0.006).</span></span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif"><span style="color:black">In this medium-volume center, the use of high power short duration catheters is associated </span></span></span><span style="font-size:9pt"><span style="font-family:&quot;Aptos Display&quot;,sans-serif">with shorter procedures, reduced radiation exposure, and significantly lower recurrence rates compared <span style="color:black">to standard power ablation, suggesting improved procedural </span>efficiency and effectiveness in AF <span style="color:black">ablation which allows to overcome the burden of demanding waiting lists for AF ablation without compromising outcomes. </span></span></span></span></span></span></p>