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.