Ca-536-01 Pulsed-Field Ablation Based Pulmonary Vein Isolation: Acute Safety and Efficacy in a Multi-Center Real World Scenario

Lemoine, Marc D.; Fink, Thomas; Mencke, Celine; My, Ilaria; Rottner, Laura; Obergassel, Julius; Muenkler, Paula; Bergau, Leonard; Moser, Fabian; Moser, Julia; Dinshaw, Leon; Reißmann, Bruno; Ouyang, Feifan; Kirchhof, Paulus; Sommer, Philipp; Rillig, Andreas; Sohns, Christian; Metzner, Andreas

doi:10.1016/j.hrthm.2022.03.759

Cited by 3 publications

(4 citation statements)

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“…Venous blood samples before and after successful PVI showed an increase of hsTropI and S100B plasma concentration in PFA (S100B: 34±2 to 62±6 pg/mL, hsTropI: 11±2 to 429±87 pg/mL; P<0.001) and CBA (S100B: 38±5 to 106±8 pg/mL, hsTropI: 5±1 to 168±32 pg/mL; P<0.001). The release of S100B was 2 to 3 times lower in PFA (28±6; 25 [9-35] pg/mL) than in CBA (68±7, 54 [37-92] pg/mL; P<0.001), whereas the increase of hsTropI was 3 Heart rate was evaluated in patients in sinus rhythm from resting ECG before and after PVI in a cohort of patients with paroxysmal atrial fibrillation. Heart rates after PFA-PVI were unchanged (from 64±10 to 64±10/ minute; P=0.989) but increased after CBA-PVI (from 61±10 to 71±9/minute; P<0.001).…”

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confidence: 99%

“…Patients were included consecutively after study approval by the ethics committee in Hamburg (REGIS-TRATION: URL: https://www.clinicaltrials.gov; TRUST registry, NCT05521451, 2020-10066-BO). Blood was obtained in patients undergoing a first PVI using the PFA pentaspline catheter (Farawave, Farapulse, Boston Scientific) 3 or CBA (Arctic Front Advance Pro, Medtronic) before and after PVI (20.8±9.1 min after isolation of left PVs with PFA and 20.0±5.1 minute with CBA; P=0.756). All procedures were performed under deep sedation applying propofol and fentanyl.…”

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confidence: 99%

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Pulmonary Vein Isolation by Pulsed-field Ablation Induces Less Neurocardiac Damage Than Cryoballoon Ablation

Lemoine

Mencke

Nies

et al. 2023

Circ: Arrhythmia and Electrophysiology

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confidence: 99%

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confidence: 99%

Pulmonary Vein Isolation by Pulsed-field Ablation Induces Less Neurocardiac Damage Than Cryoballoon Ablation

Lemoine

Mencke

Nies

et al. 2023

Circ: Arrhythmia and Electrophysiology

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“… 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 The other eight were from data presented at conferences and published as abstracts. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 The sample size for these studies was 485 participants (Supporting Information File).…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of novel pulsed field ablation (PFA) technique for atrial fibrillation: A systematic review and meta‐analysis

Shaheen

Ramadan

et al. 2023

Health Science Reports

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Background and Aim Pulse field ablation (PFA) has emerged as a safe alternative to other catheter ablation energy sources for patients. Although early results are encouraging, secondary data about outcomes are lacking. Herein, we aimed to assess the safety and efficacy of the novel technique. Methods We searched PubMed, Ovid, Google Scholar, Web of Science, and Scopus databases and several major scientific conferences for studies reporting results regarding PFA. Results Sixteen studies were included, reporting 485 patients with atrial fibrillation who underwent pulsed field operations. Patients averaged 60 years of age. The total duration of the procedure is 94 min. The average Fluoro procedure takes 17 min. Isolation of all pulmonary veins was 100% with a 95% confidence interval (CI) ( p > 0.05). Overall, the recurrence rate of arrhythmia in the participants was 2.84% (95% CI) ( p > 0.05). Complications were detected during or after the PFA procedure at a rate of 2.23% ( p < 0.05), with 95% CI indicating the high safety of the PFA procedure Conclusion Using pulsed‐field ablation as a new treatment for atrial fibrillation has proven safe and effective.

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“… 24 , 25 One single-centre study reports acute bidirectional block in 84% of anterior lines with a focal PFA tip catheter (standard RF catheters with use of a PFA generator) during a median time of 26 min. 26 Another study reporting on the first commercial use of the lattice-tip catheter with dual energy possibilities, all linear lesions beyond PVI were successfully blocked with PF or the use of PFA combined with RFC, all within a few minutes ablation time (minimal 2 min, maximal 14.7 min). 27 To date, in the largest study, investigating the focal lattice-tip catheter, all 30 roof lines created by PFA with an improved waveform were chronically blocked after evaluation during a three-month invasive remapping EP study, favouring a lattice-tip catheter design for creation of linear PFA lesions.…”

Section: Discussionmentioning

confidence: 99%

Contemporary catheter ablation of complex atrial tachycardias after prior atrial fibrillation ablation: pulsed field vs. radiofrequency current energy ablation guided by high-density mapping

Gunawardene,

Harloff,

Jularic

et al. 2024

Europace

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Background Catheter-ablation (CA) of post-ablation left-atrial tachycardias (LAT) can be challenging. So far, pulsed-field ablation (PFA) has not been compared to standard point-by-point radiofrequency-current (RFC) energy for LAT ablation. Aims To compare efficacy of PFA versus RFC in patients undergoing CA for LAT. Methods Consecutive patients undergoing LAT-CA were prospectively enrolled (09/2021-02/2023). After electro-anatomical high-density mapping, ablation with either a pentaspline PFA-catheter or RFC was performed. Patients were matched 1:1. Ablation was performed at the assumed critical isthmus site with additional ablation, if necessary. Right-atrial-tachycardia (RAT) were ablated with RFC. Acute and chronic success were assessed. Results Fifty-six patients (n=28 each group, age 70 ± 9 years,75% male) were enrolled. A total of 77 AT (n=67 LAT, n=10 RAT; 77% macroreentries) occurred with n=32 LAT in the PFA- and n=35 LAT in the RFC-group. Of all LAT, 94% (PFA-group) vs. 91% (RFC-group) successfully terminated to sinus rhythm or another AT during ablation (p=1.0). Procedure times were shorter (PFA: 121 ± 41 vs. RFC: 190 ± 44 mins, p<0.0001) and fluoroscopy times longer in the PFA-group (PFA: 15 ± 9 vs. RFC: 11 ± 6mins, p=0.04). There were no major complications. After one-year follow-up, estimated arrhythmia-free survival was 63% (PFA-group) and 87% (RFC-group), (Hazard-Ratio 2.91 (95-%-CI: 1.11-7.65), p=0.0473). Conclusion PFA of post-ablation LAT using a pentaspline catheter is feasible, safe and faster but less effective compared to standard RFC ablation after one-year of follow-up. Future catheter-designs and optimization of the electrical field may further improve practicability and efficacy of PFA for LAT.

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Ca-536-01 Pulsed-Field Ablation Based Pulmonary Vein Isolation: Acute Safety and Efficacy in a Multi-Center Real World Scenario

Cited by 3 publications

References 0 publications

Pulmonary Vein Isolation by Pulsed-field Ablation Induces Less Neurocardiac Damage Than Cryoballoon Ablation

Pulmonary Vein Isolation by Pulsed-field Ablation Induces Less Neurocardiac Damage Than Cryoballoon Ablation

Efficacy and safety of novel pulsed field ablation (PFA) technique for atrial fibrillation: A systematic review and meta‐analysis

Contemporary catheter ablation of complex atrial tachycardias after prior atrial fibrillation ablation: pulsed field vs. radiofrequency current energy ablation guided by high-density mapping

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