Feasibility and mid-term effectiveness of focal pulsed field ablation for ventricular arrhythmias.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-02-10 DOI:10.1016/j.hrthm.2025.02.014

Martin H Ruwald, Arne Johannessen, Rene Worck, Morten Lock Hansen, Martin Haugdal, Jim Hansen

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引用次数: 0

Abstract

Background: Pulsed field ablation (PFA) is a promising novel method of atrial ablation with preclinical data suggesting it to be a viable option for ventricular arrhythmias.

Objective: The objective was to report the feasibility, safety, and clinical efficacy of PFA for ventricular arrhythmias.

Methods: All-comer patients scheduled for ablation of premature ventricular complexes (PVC) or ventricular tachycardia (VT) (n=35, 24 PVC, 11 VT) underwent focal PFA using a PF generator and irrigated ablation catheters. Procedural and clinical outcomes were evaluated by 3-months Holter monitoring, implantable cardioverter defibrillator home monitoring, and chart review.

Results: A total of 11 (31%) of the patients had experienced previously failed radiofrequency ablation. Most PVC (58%) originated from the outflow tracts and most VTs were caused by ischemic cardiomyopathy (55%). Average procedure time was 187 ± 59 minutes. Acute procedural success was achieved in 91% of the patients. PFA was delivered combined endocardially and through the cardiac venous system in 25% of the PVC patients. During a mean follow-up of 288 ± 149 days the success was 75% for PVCs and 45% for VTs. A total of 5 patients were re-ablated during follow-up (4 VT, 1 PVC). We observed 7 (20%) complications including two transient conduction system blocks related to PF delivery and one stroke and one minor stroke.

Conclusion: Focal PFA exhibited satisfactory acute effectiveness for PVC and VT, but favourable clinical effectiveness was retained only in PVC patients. More data is needed to establish lesion durability, safety, and limitations of PFA in ventricular tissue.

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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.