Pentaspline catheter or cryoballoon for pulmonary vein plus posterior wall isolation in persistent atrial fibrillation: 1-year outcomes.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2024-12-16 DOI:10.1016/j.hrthm.2024.12.020

Luigi Pannone, Ioannis Doundoulakis, Domenico Giovanni Della Rocca, Antonio Sorgente, Antonio Bisignani, Giampaolo Vetta, Alvise Del Monte, Giacomo Talevi, Ingrid Overeinder, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Ali Gharaviri, Mark La Meir, Pedro Brugada, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis

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引用次数: 0

Abstract

Background: Left atrial posterior wall isolation (LAPWI) plus pulmonary vein isolation (PVI) can be performed with either radiofrequency, cryoballoon (CB-A) or, recently, with pulsed field ablation (PFA).

Objective: The aim of this study is: (1) to evaluate efficacy and safety of the pentaspline PFA catheter for PVI + LAPWI in patients with persistent AF undergoing an index ablation procedure and (2) to compare 1- year outcomes of PVI + LAPWI with PFA vs CB-A.

Methods: All consecutive patients undergoing to an index ablation for persistent atrial fibrillation (AF) at Universitair Ziekenhuis Brussel, Belgium, between 2021 and 2023, were retrospectively screened. Inclusion criteria were: 1) Persistent AF diagnosis following current guidelines; 2) First AF ablation procedure with PVI + LAPWI using the CB-A or the pentaspline PFA catheter; 3) 1-year follow-up completed.

Results: A total of 160 patients were included (80 with CB-A and 80 with the pentaspline PFA catheter). PVI + LAPWI was performed with success in 160 (100%) patients and isolation was confirmed at post-procedure high-density mapping in all. Compared with CB-A, PFA was associated with shorter skin-to-skin procedure time, shorter LA dwell time and shorter fluoroscopy time. At survival analysis, freedom from recurrent atrial tachyarrhythmias at 1-year follow-up was similar between CB-A and PFA groups (76.2% vs 78.8%, Log-Rank p=0.63).

Conclusion: In patients with persistent AF undergoing an index catheter ablation, the pentaspline PFA catheter is safe and effective for PVI + LAPWI. Outcomes after pentaspline PFA catheter ablation at 1-year are favorable and similar to CB-A catheter.

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来源期刊

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.