What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=13). Intervention: Very high-power short-duration (HPSD) radiofrequency ablation (successful lesions without local capture) vs. Unsuccessful lesions (with local capture). Primary outcome: Average contact force (g) (p=<0.01).

What does this research mean for the field?

Higher average contact force, higher maximum temperature, and better catheter stability are significantly associated with successful acute lesion delivery during very high-power short-duration ablation for atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate how biophysical parameters relate to the effectiveness of atrial fibrillation ablation lesions using a high-power strategy.

May 19, 2026Cureus0 citationsOpen Access

Assessment of Biophysical Parameters and Acute Lesion Effectiveness in Atrial Fibrillation Ablation Using a Very High-Power Short-Duration Strategy

Q: What are the key findings of this study?

Higher average contact force (19.47 g vs 17.58 g), higher maximum temperature, and better catheter stability were significantly associated with successful acute lesion delivery during HPSD ablation.

Q: What does this research mean for the field?

Higher average contact force, higher maximum temperature, and better catheter stability are significantly associated with successful acute lesion delivery during very high-power short-duration ablation for atrial fibrillation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

This study aims to evaluate how biophysical parameters relate to the effectiveness of atrial fibrillation ablation lesions using a high-power strategy.

STSana Tahir JRJoseph Rogers VSViraj Shetty

Key Result

Higher average contact force (19.47 g vs 17.58 g), higher maximum temperature, and better catheter stability were significantly associated with successful acute lesion delivery during HPSD ablation.

Key Points

This study aims to evaluate how biophysical parameters relate to the effectiveness of atrial fibrillation ablation lesions using a high-power strategy.
Analyzed 986 ablation lesions from 13 patients undergoing radiofrequency ablation.
Assessed lesions for capture presence after pulmonary vein antral isolation.
Conducted statistical analysis with independent t-tests.
Group A had more lesions and higher measure of contact force (19.47 g vs 17.58 g, p < 0.01).
Group A also showed higher maximum temperature (44.96 °C vs 40.64 °C, p < 0.01).
Group B experienced a greater impedance drop than Group A (10.35 Ω vs 8.27 Ω, p < 0.01).

Study Design

Type

Observational (n=13)

Multicenter

Structured PICO

What biophysical parameters are associated with acute lesion effectiveness during very high-power short-duration ablation for atrial fibrillation?

Population

13 consecutive patients (yielding 986 ablation lesions) undergoing radiofrequency ablation for atrial fibrillation

Intervention

Very high-power short-duration (90 W, 4 seconds) radiofrequency ablation

Outcome

Acute lesion effectiveness (presence or absence of capture with high-output pacing at 10 mA, 2 ms)surrogate

During very high-power short-duration AF ablation, higher contact force, higher temperature, and better catheter stability are associated with acute lesion effectiveness, whereas impedance drop is not.

Main Result

Absolute Event Rate: 19.47% vs 17.58%

p-value: p=<0.01

Limitations

Single-center, single-operator study with a small sample of 13 patients
Statistical approach treated lesions as independent data points without accounting for the clustering effect within a single patient
Lack of long-term clinically meaningful outcomes such as AF recurrence and lesion durability
Does not account for patient-specific variations such as atrial wall thickness, tissue composition, and conductivity

Abstract

Background: Radiofrequency ablation (RFA) therapy is frequently performed to maintain sinus rhythm in patients with atrial fibrillation (AF). Objective: The purpose of this study was to assess the association between biophysical parameters (average contact force, maximum temperature, catheter stability, and impedance drop) and acute lesion effectiveness using a very high-power short-duration (90 W, 4 seconds, QDOT catheter, Biosense Webster, Irvine, California) ablation strategy for atrial fibrillation. Methods: We analyzed 986 ablation lesions from 13 consecutive patients who underwent RFA between June and September 2024. After the pulmonary vein antral isolation (PVAI) lesion set, each lesion was assessed for the presence or absence of capture with high-output pacing (10 mA, 2 ms). Group A included lesions with no local capture, and Group B included lesions with local capture. Lesion characteristics were obtained from data stored in the CARTONET cloud-based platform (Biosense Webster). For each lesion, average contact force, maximum temperature, impedance drop, and catheter stability were analyzed. Statistical analysis was performed using independent t-tests, treating lesions as the unit of analysis. Results: Group A had more ablation lesions, higher contact force, a higher maximum temperature, and better stability compared with Group B (Group A vs Group B: 818 vs 168 lesions, p < 0.01; 19.47 g vs 17.58 g, p < 0.01; 44.96 °C vs 40.64 °C, p < 0.01; 1.59 mm vs 9.58 mm, p < 0.01). Group B had a higher impedance drop than Group A (10.35 Ω vs 8.27 Ω, p < 0.01). There were no major complications in either group at the 30-day follow-up. Conclusion: Higher average contact force, higher temperature, and better stability were associated with successful lesion delivery utilizing a very high-power short-duration ablation strategy. In this cohort, an impedance drop beyond 8 Ω did not appear to be significantly associated with acute electrical isolation.

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