{"id":390,"date":"2022-06-10T10:34:12","date_gmt":"2022-06-10T08:34:12","guid":{"rendered":"https:\/\/rythmologie.fr\/?p=390"},"modified":"2022-10-21T10:15:35","modified_gmt":"2022-10-21T08:15:35","slug":"high-power-versus-standard-power-radiofrequency-ablation-for-pulmonary-vein-isolation-the-short-af-study-by-adam-lee","status":"publish","type":"post","link":"https:\/\/rythmologie.fr\/index\/high-power-versus-standard-power-radiofrequency-ablation-for-pulmonary-vein-isolation-the-short-af-study-by-adam-lee\/","title":{"rendered":" High Power Versus Standard Power Radiofrequency ..."},"content":{"rendered":"

[vc_row][vc_column width=”1\/6″][\/vc_column][vc_column width=”2\/3″][vc_column_text]<\/p>\n

High Power Versus Standard Power Radiofrequency Ablation for Pulmonary Vein Isolation: The Short-AF Study. By Adam Lee<\/h2>\n

[\/vc_column_text][vc_column_text]But de l\u2019\u00e9tude :<\/strong> Comparer l\u2019efficacit\u00e9 et la s\u00e9curit\u00e9 de l\u2019isolation des veines pulmonaires en utilisant une puissance \u00e9lev\u00e9e (50W) vs une puissance \u00ab standard \u00bb (25-30W) en ciblant un ablation index \u00e0 450-550 en ant\u00e9rieur et 350-400 en post\u00e9rieur.<\/p>\n

Design de l\u2019\u00e9tude :<\/strong> Etude prospective randomis\u00e9e bi-centrique<\/p>\n

Crit\u00e8res d\u2019\u00e9valuation :<\/strong><\/p>\n

Primaire :<\/em> Dur\u00e9e pour isoler les veines pulmonaires
\nSecondaires :<\/em> temps pass\u00e9 dans l\u2019oreillette gauche, Isolation des veines pulmonaires apr\u00e8s le premier passage, augmentation de la temp\u00e9rature \u0153sophagienne, reconnexion apr\u00e8s test \u00e0 l\u2019ad\u00e9nosine, \u00e9v\u00e8nements ind\u00e9sirables graves \u00e0 30 jours (d\u00e9c\u00e8s, AVC, AIT, tamponnade, fistule oeso-atriale, saignement majeur),
\nAbsence de r\u00e9cidive d\u2019arythmie cardiaque apr\u00e8s une p\u00e9riode de blanking de 3 mois. Pr\u00e9sence d\u2019emboles c\u00e9r\u00e9braux silencieux r\u00e9cents sur l\u2019IRM post ablation.<\/p>\n

Crit\u00e8res d\u2019inclusion :<\/strong><\/p>\n

Patients adress\u00e9s pour ablation de FA paroxystique ou persistante <1 an. Exclusion si ant\u00e9c\u00e9dent d\u2019ablation de FA, d\u2019embole c\u00e9r\u00e9bral datant de moins de 6 mois, de stimulateur ou d\u00e9fibrillateur cardiaque ou de fraction d\u2019\u00e9jection \u226435%.<\/p>\n

R\u00e9sultats<\/strong><\/p>\n

Soixante patients (\u00e2ge m\u00e9dian : 66, 75% homme) avec FA paroxystique (57%) ou persistante (43%)<\/p>\n

En aigu :<\/em> Le temps m\u00e9dian pour obtenir l\u2019isolation des VP \u00e9tait plus court dans le groupe 50 W vs 25-30W (87 vs 126 minutes ; p = 0.003). Pas de diff\u00e9rence pour les autres param\u00e8tres m\u00eame si tendance \u00e0 avoir plus d\u2019emboles c\u00e9r\u00e9braux silencieux dans le groupe 50W (40% vs 17% ; p = 0.053, Figure B).<\/p>\n

A 1 an :<\/em> Moins de r\u00e9cidive dans le groupe 50W, (3\/29 [10%]) vs (11\/31 [35%], p = 0.032) figure A<\/p>\n

Discussion<\/strong><\/p>\n

Comme cela est r\u00e9guli\u00e8rement fait actuellement, l\u2019utilisation d\u2019une puissance de 50W est plus efficace pour l\u2019isolation des veines pulmonaires. En revanche, le nombre plus \u00e9lev\u00e9 d\u2019emboles c\u00e9r\u00e9braux silencieux bien que non significatif (mais \u00e9tude non dimensionn\u00e9e pour montrer cela) pose question et devra \u00eatre r\u00e9\u00e9valu\u00e9 pr\u00e9cis\u00e9ment. A noter que la pr\u00e9sence d\u2019emboles c\u00e9r\u00e9braux silencieux a d\u00e9j\u00e0 \u00e9t\u00e9 d\u00e9crite \u00e0 la suite des proc\u00e9dures intracardiaques gauches.<\/p>\n

Frederic Sacher, Bordeaux<\/em><\/p>\n

[\/vc_column_text][vc_single_image image=”384″ img_size=”full” alignment=”center”][\/vc_column][vc_column width=”1\/6″][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

[vc_row][vc_column width=”1\/6″][\/vc_column][vc_column width=”2\/3″][vc_column_text] High Power Versus Standard Power Radiofrequency Ablation for Pulmonary Vein Isolation: The Short-AF Study. By Adam Lee [\/vc_column_text][vc_column_text]But de l\u2019\u00e9tude : Comparer l\u2019efficacit\u00e9 et la s\u00e9curit\u00e9 de l\u2019isolation des veines pulmonaires en utilisant une puissance \u00e9lev\u00e9e (50W) vs une puissance \u00ab standard \u00bb (25-30W) en ciblant un ablation index \u00e0 450-550 en…<\/p>\n","protected":false},"author":2,"featured_media":384,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[31,22],"tags":[],"class_list":["post-390","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsletter","category-articles","category-31","category-22","description-off"],"_links":{"self":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/390","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/comments?post=390"}],"version-history":[{"count":1,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/390\/revisions"}],"predecessor-version":[{"id":395,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/posts\/390\/revisions\/395"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media\/384"}],"wp:attachment":[{"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/media?parent=390"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/categories?post=390"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rythmologie.fr\/index\/wp-json\/wp\/v2\/tags?post=390"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}