{'fraction_non_alphanumeric': 0.030206677265500796, 'fraction_numerical': 0.033386327503974564, 'mean_word_length': 5.293333333333333, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Procedural efficacy and safety of standardized, Ablation Index guided fixed 50W high power short duration pulmonary vein isolation and substrate modification using the CLOSE protocol

Introduction: Ablation Index guided ablation according to the CLOSE
protocol is very effective in terms of chronic pulmonary vein isolation
(PVI). However, the optimal RF power remains controversial. Here, we
thought to investigate the efficiency and safety of an AI guided fixed
circumferential 50W high power short duration (HPSD) PVI using the CLOSE
protocol Methods and results: In a single-centre prospective “proof of
concept” trial 40 patients underwent randomized PVI using AI guided RF
ablation without oesophageal temperature monitoring. In 20 patient fixed
50W HPSD was used irrespective to the anatomical localization. 20
subjects were ablated with standard power settings (20W posterior and
40W roof and anterior wall). Additionally, 80 consecutive patients were
treated according to the HPSD protocol to gather additional safety data.
All patients underwent post-procedural oesophago-gastro-duodenoscopy to
reveal oesophageal lesions (EDEL). The mean total procedural time was
80.3±22.5 minutes in HPSD compared to control 109.1±27.4
(p<0.001). The total RF-time was significantly lower in HPSD
1379±505 sec vs. control 2374±619 sec (p<0.001).There were no
differences in periprocedural complications. EDEL occurred in 13% in
the HPSD and 10% in control group. EDEL occurring in the 50W HSDP
patients were smaller, more superficial and had a faster healing
tendency. Conclusions: A fixed 50W HPSD circumferential PVI relying to
the ablation index and CLOSE protocol reduces the total procedure time
and the total RF time compared to standard CLOSE protocol, without
increasing the complication rates. The incidence of oesophageal lesions
was similar using 50W at the posterior atrial wall.