Complications associated with pulsed field ablation vs radiofrequency catheter ablation of atrial fibrillation.

IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Min Soo Cho, So-Ryoung Lee, Eric Black-Maier, Kevin P Jackson, Daniel J Friedman, Sean D Pokorney, Zak Loring, Janice Febre, Jonathan P Piccini
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引用次数: 0

Abstract

Background: The first commercial systems for pulsed field ablation (PFA) were recently approved by the Food and Drug Administration, but their safety profile in nationwide practice remains underexplored.

Objectives: This study aimed to describe reported adverse events with PFA systems after their market release and to compare the relative proportion of complications associated with PFA vs radiofrequency (RF) ablation catheters.

Methods: We conducted a search of the Manufacturer and User Facility Device Experience database for adverse event reports involving Food and Drug Administration-approved PFA and RF catheters from January 1, 2024, to July 31, 2024.

Results: A total of 1237 reports detailing clinical complications (n=156 for PFA and n=315 for RF) or catheter malfunctions (n=336 for PFA and n=430 for RF) were analyzed. The most common adverse events reported for PFA were pericardial effusion, vasovagal response, and hemolysis, compared with pericardial effusion, ischemic stroke, and esophageal damage for RF ablation. The proportion of reported adverse events that were deaths was lower with PFA than with RF (2.6% vs 8.9%; P=.010). Hemolysis (9.0% vs 0%), coronary events (5.8% vs 0.6%), and vasovagal responses (14.1% vs 0%) were reported more frequently after PFA (P<.001 for all). In contrast, esophageal damage (0% vs 4.1%; P<.001) and pulmonary vein stenosis (0% vs 1.9%; P=.184) were not reported with PFA, but only with RF. Regarding catheter malfunctions, mechanical problems were reported in higher proportion after PFA than after RF (87.2% vs 17.2%; P<.001).

Conclusion: The reported complications associated with PFA and RF ablation differ significantly. Close attention to PFA-specific complications is essential for ensuring the safe use of PFA and for mitigating risk.

脉冲场消融术与射频导管消融术治疗心房颤动的并发症。
背景:美国食品和药物管理局(FDA)最近批准了首批脉冲场消融(PFA)商用系统,但对其在全国范围内的安全性仍缺乏研究:本研究旨在描述脉冲场消融系统上市后的不良事件报告,并比较脉冲场消融与射频消融导管相关并发症的相对比例:我们在制造商和用户设施设备经验数据库中搜索了2024年1月1日至2024年7月31日期间涉及FDA批准的PFA和射频导管的不良事件报告:结果:共分析了 1,237 份报告,详细描述了临床并发症(PFA 报告为 156 份,RF 报告为 315 份)或导管故障(PFA 报告为 336 份,RF 报告为 430 份)。PFA最常见的不良事件是心包积液、血管迷走神经反应和溶血,RFA最常见的不良事件是心包积液、缺血性中风和食管损伤。与射频相比,PFA 报告的不良事件中死亡比例较低(2.6% 对 8.9%,P=0.010)。溶血(9.0% vs. 0%)、冠状动脉事件(5.8% vs. 0.6%)和血管迷走神经反应(14.1% vs. 0%)在 PFA 后的报告频率更高(全部为 PC结论:所报告的与 PFA 和射频消融相关的并发症差异很大。密切关注 PFA 特异性并发症对于确保安全使用 PFA 和降低风险至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart rhythm
Heart rhythm 医学-心血管系统
CiteScore
10.50
自引率
5.50%
发文量
1465
审稿时长
24 days
期刊介绍: HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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