# Clinical impact of very high‐power‐short‐duration catheters on biomarkers after atrial fibrillation ablation

## TL;DR

Using a new type of catheter during heart procedures reduces fluid use and lowers heart failure risk markers compared to traditional methods.

## Contribution

Demonstrates that vHPSD catheters reduce irrigation fluid and biomarker changes linked to heart failure during AF ablation.

## Key findings

- vHPSD catheters used 434.8 mL vs. 806.6 mL of irrigation fluid compared to standard catheters.
- BNP levels increased significantly less in patients using vHPSD catheters.
- CRP levels also increased less in the vHPSD group post-procedure.

## Abstract

Very high‐power short‐duration (vHPSD) catheters are associated with less irrigation fluid load than standard (STD RF) ablation catheters. However, the impact of this fluid reduction on biomarkers in pulmonary vein isolation (PVI) for atrial fibrillation (AF) remains unknown.

Biomarkers of heart failure, myocardial injury, and systemic inflammation status as Brain Natriuretic Peptide (BNP), high‐sensitivity Troponin I (hsTnI), and C‐reactive protein (CRP) were collected pre‐ and post‐procedure of PVI for symptomatic AF. The study aimed to assess the impact of vHPSD catheter compared to an STD catheter (respectively irrigation of 8 vs. 15 mL/min during ablation) on biomarker alterations.

The study included 83 consecutive patients (59 males [71.1%], mean age 62.6 ± 11 years), with vHPSD catheters used in 53 cases (63.9%). No significant baseline differences were observed between groups.Fluid irrigation resulted in significantly lower with vHPSD catheter than STD RF (434.8 ± 105.6 vs. 806.6 ± 256.5 mL, p < .001). Correspondingly, BNP variation was significantly lower in the vHPSD group than in the STD RF group, both in absolute change (12 [IQR −9–47] pg/mL vs. 44.5 [IQR 21–88.7] pg/mL, p = .002) and percentage change (16.3 [IQR −13.2–108.6] % vs. 84.1 [IQR 32.5–172.1] %, p = .012). When considering absolute values, a statistically significant increase in BNP was found only in the STD catheter group (from 52 [IQR 35.2–113.5] to 113 [IQR 66.7–189.5] pg/mL, p < .001), whereas no significant increase was observed in the vHPSD group (p = .06). CRP levels increased post‐PVI in both groups, but the delta was significantly lower in the vHPSD group (p = .025). No significant differences in post‐procedural hsTnI were detected between groups.

The use of a vHPSD catheter is associated with reduced fluid irrigation and a correspondingly smaller increase in BNP, a biomarker indicative of fluid overload and heart failure.

Differences in fluid irrigation (A), pre‐ and post‐procedure BNP absolute values change (B), and BNP percentage values change (C) in standard catheters (STD RF) versus very high‐power short‐duration catheters (vHPSD). vHPSD catheters use is associated with significantly less irrigation fluid than with standard STD RF catheters during pulmonary vein isolation for atrial fibrillation. This reduced fluid load is associated with a significantly smaller increase in BNP levels, suggesting a lower impact on fluid overload and reducing the risk of heart failure.