Very high-power short duration radiofrequency ablation to achieve pulmonary vein isolation: the AIR HPSD registry

The QDOT Micro catheter allows to perform a very high-power short-duration ablation that produces wider and shallower lesions. This study aims to corroborate the evidences on the safety, acute and long-term efficacy of this catheter by providing a large real-world dataset. The AIR HPSD Registry is a multicentric prospective registry across 26 European centers that enrolled consecutive atrial fibrillation (AF) patients undergoing their first pulmonary vein (PV) isolation. In all patients a wide antrum circumferential ablation aimed at PV isolation was performed using the QDOT Micro catheter in QMode+ (90 w for 4 s) for the whole ablation or in a hybrid mode (QMode + for the posterior wall and QMode guided by ablation index for the anterior wall), according to the operators’ preference. Overall, 982 patients have been enrolled, 38% of patients were ablated with the QMode + solely and 62% with a hybrid modality. The fluoroscopy time was higher in the hybrid group (396 ± 493 s vs. 138 ± 238 s, p < 0.001) and similarly the procedural time (112 ± 41 min vs. 96 ± 36 min, p = 0.01). The complications (1.8%) were similar between groups (1.1% in Qmode+ group vs. 2.3% in hybrid group, p = 0.3). The freedom from AF/AT recurrence was similar between groups (88% hybrid group vs. 90% Qmode+ group, p = ns) and higher in paroxysmal than in persistent patients (90% vs. 81%, p < 0.001). The QDOT Micro catheter demonstrated high efficiency, safety, and effectiveness in achieving PV isolation in patients undergoing their first ablation for paroxysmal or persistent AF.

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Publication Details

Journal
Journal of Interventional Cardiac Electrophysiology
Published
2026-03-31
DOI
https://doi.org/10.1007/s10840-026-02269-y
Primary Topic
Atrial Fibrillation Management and Outcomes
Type
article
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article

Very high-power short duration radiofrequency ablation to achieve pulmonary vein isolation: the AIR HPSD registry

Giulio Zucchelli, Claudio Pandozi, Giacomo Mugnai, Antoine Lepillier et al.
Journal of Interventional Cardiac Electrophysiology
Atrial Fibrillation Management and Outcomes
article

Very high-power short duration radiofrequency ablation to achieve pulmonary vein isolation: the AIR HPSD registry

Giulio Zucchelli, Claudio Pandozi, Giacomo Mugnai, Antoine Lepillier, Marzia Giaccardi, Adrian Gwizdała, Vincenzo Schillaci, Procolo Marchese, Graziana Viola, Teresa Strisciuglio, Saverio Iacopino, Sarah Zeriouh, Tomasz Kryński, Luca Rebellato, Ieva Ansaberga, Paolo Compagnucci, Kiran Kang, Marco Gallucci, Claire A Martin, Giuseppe Stabile, Francesco Solimene, Alexandre Bodin, Kaspars Kupics, Roberto Mantovan, Piotr Kulakowski, Luca Rossi, Massimo Grimaldi, Andrea Giomi, Sara Poggi, Antonio Dello Russo, Maria Luisa Loricchio, Marcello Anders Piacenti, Maria Lucia Narducci, Kristine Jubele, Matteo Anselmino, Gemma Palergonio, Marco Scaglione
article en

Abstract

The QDOT Micro catheter allows to perform a very high-power short-duration ablation that produces wider and shallower lesions. This study aims to corroborate the evidences on the safety, acute and long-term efficacy of this catheter by providing a large real-world dataset. The AIR HPSD Registry is a multicentric prospective registry across 26 European centers that enrolled consecutive atrial fibrillation (AF) patients undergoing their first pulmonary vein (PV) isolation. In all patients a wide antrum circumferential ablation aimed at PV isolation was performed using the QDOT Micro catheter in QMode+ (90 w for 4 s) for the whole ablation or in a hybrid mode (QMode + for the posterior wall and QMode guided by ablation index for the anterior wall), according to the operators’ preference. Overall, 982 patients have been enrolled, 38% of patients were ablated with the QMode + solely and 62% with a hybrid modality. The fluoroscopy time was higher in the hybrid group (396 ± 493 s vs. 138 ± 238 s, p < 0.001) and similarly the procedural time (112 ± 41 min vs. 96 ± 36 min, p = 0.01). The complications (1.8%) were similar between groups (1.1% in Qmode+ group vs. 2.3% in hybrid group, p = 0.3). The freedom from AF/AT recurrence was similar between groups (88% hybrid group vs. 90% Qmode+ group, p = ns) and higher in paroxysmal than in persistent patients (90% vs. 81%, p < 0.001). The QDOT Micro catheter demonstrated high efficiency, safety, and effectiveness in achieving PV isolation in patients undergoing their first ablation for paroxysmal or persistent AF.

Journal of Interventional Cardiac Electrophysiology
Poznan University of Medical Sciences (PL), Marche Polytechnic University (IT), University of Cambridge (GB), Medical University of Warsaw (PL), Santa Maria Nuova Hospital (IT), Royal Papworth Hospital (GB), Agostino Gemelli University Polyclinic (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Azienda Ospedaliera Universitaria Integrata Verona (IT), Centre Hospitalier Universitaire de Tours (FR), AULSS 2 Marca Trevigiana (IT), Ospedale San Filippo Neri (IT), Pauls Stradiņš Clinical University Hospital (LV), Maria Cecilia Hospital (IT), Azienda Sanitaria Locale di Asti (IT), Ospedale Santa Maria Annunziata (IT), Clinica Mediterranea (IT), Presidio Ospedaliero (IT), Santissima Trinità (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Ospedale Sandro Pertini (IT), Postgraduate School of Molecular Medicine (PL), Guglielmo da Saliceto Hospital (IT), Ospedale Generale Regionale Francesco Miulli (IT), Centre Cardiologique du Nord (FR), Fondazione Toscana Gabriele Monasterio (IT), Azienda Ospedaliera Universitaria Pisana (IT), Poznań University of Technology (PL)
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