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
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 radiofrequency ablation, cryoballoon ablation (CB-A), or, recently, pulsed field ablation (PFA).

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

Methods: All consecutive patients undergoing an index ablation for persistent atrial fibrillation (AF) at Universitair Ziekenhuis Brussel, Belgium, between 2021 and 2023 were retrospectively screened. Inclusion criteria were persistent AF diagnosis following current guidelines, first AF ablation procedure with PVI + LAPWI using the CB-A or the pentaspline PFA catheter, and 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 postprocedure high-density mapping in all. Compared with CB-A, PFA was associated with shorter skin-to-skin procedure time, shorter left atrium dwell time, and shorter fluoroscopy time. At survival analysis, freedom from recurrent atrial tachyarrhythmias at 1-year follow-up was similar between the CB-A and PFA groups (76.2% vs 78.8%; log-rank P = .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 those with the CB-A catheter.

持续性房颤患者肺动脉置管或低温球囊加后壁隔离:1年疗效
背景:左心房后壁隔离(LAPWI)加肺静脉隔离(PVI)可以通过射频、低温球囊(CB-A)或最近的脉冲场消融(PFA)进行。目的:本研究的目的是:(1)评估经指数消融治疗的持续性房颤患者PVI + LAPWI使用pentaspline PFA导管的有效性和安全性;(2)比较PVI + LAPWI与PFA与CB-A的1年预后。方法:回顾性筛选2021年至2023年间在比利时布鲁塞尔Ziekenhuis大学接受持续性房颤(AF)指数消融的所有连续患者。纳入标准为:1)持续性房颤诊断符合现行指南;2)首次使用CB-A或pentaspline PFA导管PVI + LAPWI消融房颤;3)随访1年。结果:共纳入160例患者,其中CB-A组80例,pentaspline PFA组80例。160例(100%)患者成功进行了PVI + LAPWI,所有患者在术后高密度测绘中均证实了隔离。与CB-A相比,PFA与更短的皮肤对皮肤手术时间、更短的LA停留时间和更短的透视时间相关。在生存分析中,1年随访时,CB-A组和PFA组复发性房性心动过速的发生率相似(76.2% vs 78.8%, Log-Rank p=0.63)。结论:对于持续性房颤患者行导管消融治疗,pentaspline PFA导管对于PVI + LAPWI是安全有效的。pentaspline PFA导管消融后1年的预后良好,与CB-A导管相似。
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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