{"id":"fe723db1ba2b","type":"article","url":"https://hartvaat.nl/2025/08/04/zeer-hoog-vermogen-70w-rf-ablatie-met-flexibele-tip-voor-pvi-bij-af/","title":"Zeer hoog vermogen (70W) RF-ablatie met flexibele tip voor PVI bij AF","title_en":"Very high-power short-duration using 70W and a flexible tip ablation catheter for pulmonary vein isolation: the POWER PULSE randomized controlled trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"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","doi":"10.1093/europace/euaf105","source_url":"https://doi.org/10.1093/europace/euaf105","authors":["Miruna A Popa","Hannah Krafft","Fabian Bahlke","Florian Englert","Sarah Lengauer","Marta Telishevska","Nico Erhard","Madeleine Tydecks","Martin Hadamitzky","Felix Bourier","Tilko Reents","Elisabeth Klupp","Carsten Lennerz","Gabriele Hessling","Isabel Deisenhofer","Marc Kottmaier"],"significance":5,"published":"2025-08-04","source_date":"2025-08-04","image":"","kennis":[],"congress":"","summary_en":"The POWER PULSE trial evaluated very high-power short-duration radiofrequency ablation at 70W with a flexible-tip catheter for pulmonary vein isolation in paroxysmal AF. The technique achieved rapid and effective PVI with an acceptable safety profile.","created":"2026-07-03T10:31:47Z","updated":"2026-07-03T13:30:46Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie onderzocht zeer-hoog-vermogen (70W) RF-ablatie met flexibele tipcatheter voor PVI. De techniek was snel en effectief met aanvaardbaar veiligheidsprofiel.","abstract_original":"AIMS: Very high-power short-duration (vHPSD) was developed to optimize radiofrequency ablation for atrial fibrillation (AF). However, data on vHPSD ≥ 70W remains limited. We investigated acute efficacy, safety and long-term rhythm outcomes of vHPSD-70W in a randomized controlled trial. METHODS AND RESULTS: A total of n = 200 patients with paroxysmal AF were randomly assigned 1:1 to receive pulmonary vein isolation (PVI) using vHPSD (70 W/5-7 s) or standard (30-40W, 20-40 s) ablation with a flexible, enhanced-irrigation tip catheter. Primary endpoint was the number of reconnected pulmonary veins (rPV) after adenosine testing. Secondary endpoints included first-pass isolation (FPI), silent cerebral lesions (SCLs) and rhythm outcomes on 12-month follow-up. Mean number of rPVs was 0.6 ± 0.8 vs. 0.8 ± 0.9 (P = 0.145) with vHPSD-70W vs. standard ablation. Bilateral FPI was 42.7% vs. 30.2% (P = 0.072), while FPI of left PVs was higher with vHPSD-70W (63.5% vs. 49.0%, P = 0.042). Procedure (107.7 ± 34.2 vs. 131.3 ± 42.2 min) and radiofrequency (15.1 ± 6.7 vs. 41.8 ± 18.3 min) duration were significantly lower with vHPSD-70W (P < 0.001). Silent cerebral lesions occurred in 1/25 (4.0%) vs. 3/22 (13.6%, P = 0.328). On 12-month follow-up, freedom from any atrial arrhythmia (76.0% vs. 66.7%, P = 0.171) was similar, while vHPSD-70W showed a lower incidence of atrial tachycardia (AT) recurrence (1.0% vs. 10.4%, P = 0.005). CONCLUSION: Very high-power short-duration with 70 W/5-7 s was non-superior to standard ablation regarding acute PV reconnection and 12-month freedom from any atrial arrhythmia. However, vHPSD-70W achieved a higher FPI rate of left PVs with a shorter procedure duration and a comparable safety profile. AT recurrence was significantly less common with vHPSD-70W."}