BRIEF RESEARCH REPORT article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1556367
A Novel Enhanced Stability Detection Algorithm for Ablation Catheters: Purpose and Application in High-Power Short-Duration Ablation
Provisionally accepted
Chiara Valeriano1,2*
Benjamin Berte3
Ofer Klemm4Alona Sigal4Eid Zaknoun4Dimitri Buytaert1Tom De Potter1- 1Cardiovascular Center, OLV Aalst, Aaslt, Belgium
- 2Department of Advanced Biomedical Sciences, School of Medicine and Surgery, University of Naples Federico II, Napoli, Campania, Italy
- 3Hirslanden Klinik St. Anna, Lucerne, Switzerland
- 4Biosense Webster, Shfayim, Israel
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Background: Assessing catheter stability during ablation procedures is crucial. The current stability algorithm relies on end-expiration reference frame (Gated), requiring a full respiratory cycle before lesion tagging. This poses challenges with high-power, short-duration (HPSD) radiofrequency ablation workflows. To overcome these limitations, a novel algorithm, called Stability+, has been developed. It provides real-time tracking and analysis of catheter motion throughout the entire respiratory cycle.Objective: The aim of our study was to assess the performance of the new Stability+ algorithm in HPSD ablations and to compare it with the current algorithm.Methods: Data from a series of consecutive left atrial ablations employing the new Stability+ algorithm were prospectively collected. A retrospective analysis was conducted to compare the two algorithms.Results: A total of 1056 applications were delivered, 123 (11.6%) using QMODE+ (90W, 3-4 seconds), and 933 (88.4%) using QMODE (50W, ablation index guided 350/500). The number of unstable applications, outside the end-expiration phase, was detected with the Stability+ for 9 positions (7.3%) using the QMODE+. Average time-to-tag appearance was 2.5±1 seconds with the Stability+ vs 9±1.1 seconds with the Gated algorithm. During QMODE ablation sessions, the Stability+ algorithm prevented overshooting in 84% of the ablation positions. No steam pop or perforation occurred.Conclusion: The novel Stability+ algorithm enhances lesion tracking for HPSD workflows like QMODE+/QMODE and holds the potential to improve stability detection across all radiofrequency ablation modes, marking a significant advancement in the field.
Keywords: atrial fibrallation, Pulmonary vein isolation (PVI), stability +, high power short duration, Radiofreqency ablation
Received: 06 Jan 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Valeriano, Berte, Klemm, Sigal, Zaknoun, Buytaert and De Potter. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chiara Valeriano, Cardiovascular Center, OLV Aalst, Aaslt, Belgium
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