Lesion Contiguity in Very High Power-short Duration Ablation

Effect of Very High Power-short Duration Ablation on Lesion Contiguity in Pulmonary Vein Isolation as Assessed by Late Gadolinium Enhancement Cardiovascular Magnetic Resonance

This observational trial investigates the effect of very high power-short duration radiofrequency ablation on lesion contiguity as assessed by late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR). Patients with paroxysmal or early persistent atrial fibrillation (AF) scheduled for pulmonary vein isolation (PVI) undergo point-by-point ablation using the QDOT micro catheter applying Qmode+ (90W over 4 seconds). All patients receive an LGE-CMR 3 months after the procedure for ablation lesion assessment. Contiguity of LGE-CMR-detected ablation lesions will be compared with a matched control group of patients that have undergone PVI accomplished by ablation index-guided ablation with 40 W following the CLOSE protocol.

Inclusion Criteria:

• paroxysmal or early persistent (max. 3 months) atrial fibrillation
• scheduled for PVI-only catheter ablation

Exclusion Criteria:

• long-standing persistent atrial fibrillation
• previous left atrial ablation
• claustrophobia preventing CMR
• sever renal insufficiency (GFR >30 ml/min)
• gadolinium contrast allergy
• presence of implantable devices not compatible with magnetic resonance
• pregnancy and lactation