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Castrejón-Castrejón S, Martínez Cossiani M, Jáuregui-Abularach M, Basterra Sola N, Ibáñez Criado JL, Osca Asensi J, Roca Luque I, Moya Mitjans A, Quesada Dorador A, Hidalgo Olivares VM, Pérez Castellano N, Fernández Gómez JM, Macías-Ruiz MR, Bochard Villanueva B, Gonzalo Bada N, Fernández Prieto A, Guido López LE, Martínez Maldonado ME, Merino D, Escobar Cervantes C, Merino JL. Multicenter prospective comparison of conventional and high-power short duration radiofrequency application for pulmonary vein isolation: the high-power short-duration radiofrequency application for faster and safer pulmonary vein ablation (POWER FAST III) trial. J Interv Card Electrophysiol 2023; 66:1889-1899. [PMID: 36807734 DOI: 10.1007/s10840-023-01509-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Electrical isolation of pulmonary veins (PV) with high-power short-duration (HPSD) radiofrequency application (RFa) may reduce the duration of atrial fibrillation (AF) ablation, without compromising the procedural efficacy and safety in comparison with the conventional approach. This hypothesis has been generated in several observational studies; the POWER FAST III will test it in a randomized multicenter clinical trial. METHODS It is a multicenter randomized, open-label and non-inferiority clinical trial with two parallel groups. AF ablation using 70 W and 9-10 s RFa is compared with the conventional technique using 25-40 W RFa guided by numerical lesion indexes. The main efficacy objective is the incidence of atrial arrhythmia recurrences electrocardiographically documented during 1-year follow-up. The main safety objective is the incidence of endoscopically detected esophageal thermal lesions (EDEL). This trial includes a substudy of incidence of asymptomatic cerebral lesions detected by magnetic resonance imaging (MRI) after ablation. RESULTS A randomized clinical trial compares for the first time high-power short-duration and conventional ablation in order to obtain data about the efficacy and safety of the high-power technique in an adequate methodological context. CONCLUSIONS The results of the POWER FAST III could support the use of the high-power short-duration ablation in clinical practice. REGISTRATION ClinicalTrials.gov: NTC04153747.
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Affiliation(s)
- Sergio Castrejón-Castrejón
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Marcel Martínez Cossiani
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Miguel Jáuregui-Abularach
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Nuria Basterra Sola
- Cardiology Department, Complejo Hospitalario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - José Luis Ibáñez Criado
- Cardiology Department, Hospital General Universitario de Alicante-ISABIAL (Instituto de Investigación Sanitaria Y Biomédica de Alicante), Alicante, Spain
| | | | - Ivo Roca Luque
- Cardiology Department, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | | | | | | | - Nerea Gonzalo Bada
- Acute Care Unit, Department of Gastroenterology, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | | | - Leonardo Elías Guido López
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | | | - Daniel Merino
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Carlos Escobar Cervantes
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - José Luis Merino
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
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Arbelo E, Angera I, Trucco E, Rivas-Gándara N, Guerra JM, Bisbal F, Jáuregui-Abularach M, Vallés E, Martin G, Sbraga F, Tolosana JM, Linhart M, Francisco-Pascual J, Montiel-Serrano J, Pereferrer D, Menéndez-Ramírez D, Jiménez J, Elamrani A, Borrás R, Dallaglio PD, Benito E, Santos-Ortega A, Rodríguez-Font E, Sarrias A, González-Matos CE, Martí-Almor J, Cabrera S, Mont L. Reduction in new cardiac electronic device implantations in Catalonia during COVID-19. Europace 2021; 23:456-463. [PMID: 33595062 PMCID: PMC7928966 DOI: 10.1093/europace/euab011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/13/2021] [Indexed: 12/27/2022] Open
Abstract
Aims During the COVID-19 pandemic, concern regarding its effect on the management of non-communicable diseases has been raised. However, there are no data on the impact on cardiac implantable electronic devices (CIED) implantation rates. We aimed to determine the impact of SARS-CoV2 on the monthly incidence rates and type of pacemaker (PM) and implantable cardiac defibrillator (ICD) implantations in Catalonia before and after the declaration of the state of alarm in Spain on 14 March 2020. Methods and results Data on new CIED implantations for 2017–20 were prospectively collected by nine hospitals in Catalonia. A mixed model with random intercepts corrected for time was used to estimate the change in monthly CIED implantations. Compared to the pre-COVID-19 period, an absolute decrease of 56.5% was observed (54.7% in PM and 63.7% in ICD) in CIED implantation rates. Total CIED implantations for 2017–19 and January and February 2020 was 250/month (>195 PM and >55 ICD), decreasing to 207 (161 PM and 46 ICD) in March and 131 (108 PM and 23 ICD) in April 2020. In April 2020, there was a significant fall of 185.25 CIED implantations compared to 2018 [95% confidence interval (CI) 129.6–240.9; P < 0.001] and of 188 CIED compared to 2019 (95% CI 132.3–243.7; P < 0.001). No significant differences in the type of PM or ICD were observed, nor in the indication for primary or secondary prevention. Conclusions During the first wave of the COVID-19 pandemic, a substantial decrease in CIED implantations was observed in Catalonia. Our findings call for measures to avoid long-term social impact.
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Affiliation(s)
- Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Ignasi Angera
- Arrhythmia Section, Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Emilce Trucco
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Nuria Rivas-Gándara
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - José M Guerra
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Felipe Bisbal
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Miguel Jáuregui-Abularach
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Ermengol Vallés
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gabriel Martin
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Fabrizio Sbraga
- Department of Cardiac Surgery, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - José María Tolosana
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Markus Linhart
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Jaume Francisco-Pascual
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - José Montiel-Serrano
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Damià Pereferrer
- Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Diego Menéndez-Ramírez
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Jesús Jiménez
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Amin Elamrani
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Roger Borrás
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain
| | - Paolo Domenico Dallaglio
- Arrhythmia Section, Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Eva Benito
- Arrhythmia Section, Cardiology Department, Hospital Universitari Doctor Josep Trueta. Girona, Spain.,Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Spain
| | - Alba Santos-Ortega
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Vall d'Hebron Institut de Recerca (VHIR), Centro de investigación biomédica en red de enfermedades cardiovasculares (CIBER-CV), Barcelona, Spain
| | - Enrique Rodríguez-Font
- Arrhythmia Unit, Department of Cardiology, Hospital de la Santa Creu i Sant Pau, CIBER-CV, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Axel Sarrias
- Arrhythmia Section, Cardiology Department, Heart Institute (iCOR), University Hospital Germans Trias i Pujol, Badalona, Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Carlos E González-Matos
- Arrhythmia Unit, Department of Cardiology, Hospital Universitari Arnau de Vilanova, Lleida, Spain.,Institut de Recerca Biomèdica de Lleida Fundació Dr Pifarré (IRBLleida), Lleida, Spain
| | - Julio Martí-Almor
- Arrhythmia Section, Cardiology Department, Hospital del Mar-IMIM. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sandra Cabrera
- Arrhythmia Section, Cardiology Department, Hospital Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain.,IISPV, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Lluis Mont
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació August Pi iSunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Jáuregui-Abularach M, Merchán-Ortega G, Menéndez-Ramírez D, Martín-Sánchez G, Sánchez-Millán P, Worner-Diz F, Campos-García B. Radiofrequency ablation of superoparaseptal-parahisian accessory pathways from the sinuses of Valsalva region: a three case report. J Interv Card Electrophysiol 2020; 58:119-121. [PMID: 32147800 DOI: 10.1007/s10840-020-00717-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Miguel Jáuregui-Abularach
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain.
| | - Germán Merchán-Ortega
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
| | - Diego Menéndez-Ramírez
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
| | - Gabriel Martín-Sánchez
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
| | - Pablo Sánchez-Millán
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
| | - Fernando Worner-Diz
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
| | - Bieito Campos-García
- Department of Cardiology, Hospital Universitari Arnau de Vilanova, IRBLleida, Av. Rovira Roure, 80, 25198, Lleida, Lleida, Spain
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