Clinical importance in light of novel high power, short per-site RF duration protocols
RF lesion formation occurs more rapidly at higher power.11 Recently reported high power short duration (HPSD) protocols (50W, typically ~5s per site)12,13 are attractive for operators wishing to move away from the requirement to maintain a stable catheter position for the ~20-40s previously considered necessary to achieve transmural RF effect during PVI.1,14 However, at greater rates of lesion formation, methods to immediately and accurately identify clinically relevant catheter position instability are of particular importance towards knowing attainment of target “per-site” RF delivery and reproducible protocols. However, to our knowledge no HPSD RF manuscript includes details of RMA use. Alongside the recommendation for RF annotation use (i.e. VISITAG™) with RMA “on”, this also raises the question of the validity of HPSD “per-site” ablation targets, and whether presently described HPSD RF protocols may be considered reproducible.