Is the sympathetic hyperactivity a confounding factor for the outcomes of atrial fibrillation ablation?

In their elegant study ‘Safety and outcome of very high-power short-duration ablation using 70 W for pulmonary vein isolation in patients with paroxysmal atrial fibrillation’ Kottmaieret al.1 reported that patients who underwent a high-power short-duration (HPSD) pulmonary vein isolation (PVI) ablation to treat paroxysmal atrial fibrillation (AF) had 18% fewer arrhythmia recurrences in comparison to those who were subjected to a conventional power protocol ablation after 1-year follow-up. This was mostly assigned to the fact that the HPSD technique limited the radiofrequency application time and thereby the risk for catheter motion and development of tissue oedema. Although HPSD ablation seems to result in more permanent and extensive lesions contributing to better completion of the pulmonary vein encirclement, other relevant factors should be considered.
Source: Europace - Category: Cardiology Source Type: research