Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres.

IF 2.8 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Mark T Mills, Saket Trivedi, Matthew J Lovell, Francis Murgatroyd, Peter Calvert, Vishal Luther, Dhiraj Gupta, Claire Martin, Sarah Zeriouh, Greg Mellor, Richard Balasubramaniam, Mark Sopher, Julian Boullin, Aruna Arujuna, Shajil Chalil, Scott Gall, Zhong Chen, Magdi Saba, Una Buckley, Riyaz Somani, Shui Hao Chin, David Jones, Riyaz A Kaba, Mark O'Neill, Tom Wong, Derick M Todd
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引用次数: 0

Abstract

Introduction: Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.

Methods: Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.

Results: 1034 procedures were submitted. The patients were 32.1% female, mean age 63.8±10.7 years, 53.1% paroxysmal AF and 89.7% first-time AF ablation. Procedures were performed by 48 consultant operators at nine NHSE centres, with a mean of 115 procedures per centre (range 25-264). 93.7% of procedures were performed under general anaesthesia. Median skin-to-skin procedure time was 74 min (IQR 55-96 min) and fluoroscopy time 20 min (IQR 15-27 min). Electroanatomical mapping was used in 15.3%. In first-time ablation cases, acute isolation of all pulmonary veins was achieved in 99.5% of patients. Left atrial (LA) posterior wall ablation using the PFA catheter was performed in 11.0% of cases; additional LA radiofrequency ablation was performed in 0.6%. The major and minor acute procedural complication rates were, respectively, 1.3% and 3.1%, with no reports of periprocedural death or atrio-oesophageal fistula. 63.8% of patients were discharged on the day of procedure. Follow-up data were available for 870 procedures (84.1%). In the 3 months following ablation, hospitalisation for arrhythmia occurred in 3.2%, with 0.9% rehospitalised for procedural-related complications.

Conclusion: In this real-world, nationwide registry of a pentaspline PFA catheter, efficacy, safety and efficiency outcomes were comparable to those from previous PFA studies in patients with AF.

脉冲场消融心房颤动与pentaspline导管跨英国国家卫生服务中心。
简介:脉冲场消融(PFA)是心房颤动(AF)患者肺静脉隔离的一种新方式。我们描述了在选定的英格兰国家卫生服务(NHSE)中心使用pentaspline导管进行PFA的初步吸收和经验。方法:在2022年6月至2024年8月期间,由NHSE专业服务发展计划收集的关于使用单针、pentaspline、多电极PFA导管(FARAWAVE, Boston Scientific)的房间隔消融手术的数据进行汇总和分析,以检查3个月随访期间的程序指标、急性疗效和安全性结果。结果:共提交1034例手术。女性占32.1%,平均年龄63.8±10.7岁,阵发性房颤占53.1%,首次房颤消融占89.7%。程序由9个NHSE中心的48名顾问操作员执行,每个中心平均有115个程序(范围25-264)。93.7%的手术在全身麻醉下进行。皮对皮手术时间中位数为74分钟(IQR 55-96分钟),透视时间为20分钟(IQR 15-27分钟)。15.3%采用电解剖测图。在首次消融病例中,99.5%的患者实现了所有肺静脉的急性隔离。11.0%的病例行PFA导管左房后壁消融;0.6%的患者进行了额外的LA射频消融。主要和次要急性手术并发症发生率分别为1.3%和3.1%,无术中死亡或心房-食管瘘的报告。63.8%的患者在手术当天出院。随访数据为870例(84.1%)。消融后3个月内,3.2%的患者因心律失常住院,0.9%的患者因手术相关并发症再次住院。结论:在现实世界中,在全国范围内登记的pentaspline PFA导管中,疗效、安全性和效率结果与先前在房颤患者中进行的PFA研究相当。
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来源期刊
Open Heart
Open Heart CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.60
自引率
3.70%
发文量
145
审稿时长
20 weeks
期刊介绍: Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.
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