Trial reportEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025
Very high-power short-duration using 70W and a flexible tip ablation catheter for pulmonary vein isolation: the POWER PULSE randomized controlled trial.
Trial report in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Safety and effectiveness of the TactiFlex duo system: 6-month results of the FOCALFLEX study.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 · 2026Trial
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16 authors.
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Abstract
aimsVery 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
resultsA 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).
conclusionVery 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.
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