Paroxysmal atrial fibrillation ablation with a novel temperature-controlled CF-sensing catheter: Q-FFICIENCY clinical and healthcare utilization benefits

Ayman A. Hussein, M. Craig Delaughter, George Monir, Andrea Natale, Srinivas Dukkipati, Saumil Oza, Emile Daoud, Luigi Di Biase, Moussa Mansour, Robert Fishel, Miguel Valderrabano, Kenneth Ellenbogen, Jose Osorio

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: The prospective, nonrandomized, multicenter Q-FFICIENCY study demonstrated the safety and 12-month efficacy of paroxysmal atrial fibrillation (AF) ablation with the novel QDOT MICRO temperature-controlled, contact force-sensing, radiofrequency (RF) catheter. Participants underwent pulmonary vein isolation with very high-power short-duration (vHPSD) mode (90 W, ≤4 s) alone or combined with conventional-power temperature-controlled (CPTC) mode (25–50 W). This study aimed to assess quality-of-life (QOL) and healthcare utilization (HCU) benefits experienced by Q-FFICIENCY study participants. Methods: Besides evaluating procedural efficiency, QOL and HCU were assessed through 12 months postablation via Atrial Fibrillation Effect on Quality-of-Life Tool (AFEQT) score, antiarrhythmic drug (AAD) use, and incidence of cardioversion and cardiovascular hospitalization. Results: Of 191 participants enrolled, 166 were ablated with the new catheter. Compared to baseline, statistically significant, clinically meaningful improvements in composite and subcategories of AFEQT scores were observed at 3 months and sustained through 12 months (12-month increase, 29.3–44.2 points). Class I/III AAD use decreased from 97.6% (162/166) at baseline to 19.6% (31/158) during Months 6–12, representing a significant 79.9% reduction. The cardioversion rate significantly declined by 93.9% from 31.3% (12 months preablation) to 1.9% (evaluation period). One-year Kaplan–Meier estimates of freedom from all-cause and cardiovascular hospitalization were 80.9% (95% confidence interval [CI], 74.8%–86.9%) and 88.8% (95% CI, 84.0%–93.7%), respectively. Conclusions: Paroxysmal AF ablation with the novel temperature-controlled RF catheter in vHPSD mode, alone or with CPTC mode, led to clinically meaningful improvement in QOL and significant reduction in AAD use, cardioversion, and cardiovascular hospitalization.

Original languageEnglish (US)
Pages (from-to)2493-2503
Number of pages11
JournalJournal of Cardiovascular Electrophysiology
Volume34
Issue number12
DOIs
StatePublished - Dec 2023

Keywords

  • QDOT MICRO
  • QMODE+
  • healthcare utilization
  • quality of life
  • temperature-controlled ablation
  • very high-power short-duration
  • Temperature
  • Prospective Studies
  • Humans
  • Treatment Outcome
  • Catheters
  • Catheter Ablation/adverse effects
  • Anti-Arrhythmia Agents/therapeutic use
  • Patient Acceptance of Health Care
  • Quality of Life
  • Pulmonary Veins/surgery
  • Atrial Fibrillation/diagnosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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