Incidence, types, and predictors of AF recurrence after AF ablation with pulsed field ablation. A single-centre experience Article Swipe
A Eberl
,
Martin Manninger
,
Ursula Rohrer
,
A Reischl
,
Martin Benedikt
,
Egbert Bisping
,
P. Lercher
,
Andreas Zirlik
,
Douglas S. Scherr
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euae102.813
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/europace/euae102.813
Background Pulsed field ablation (PFA) is an emerging method for the ablation of atrial fibrillation (AF). As there are few data on incidence, types, and predictors of AF recurrence after PFA for AF ablation, we are continuously analysing our cohort. Methods We report our outcome data after PVI with PFA. Each procedure was performed under deep sedation with propofol and fentanyl. Before transeptal puncture, unfractionated heparin was administered to maintain an ACT level >300sec throughout the procedure. Isolation of pulmonary veins was started after administration of 1mg of atropine with 8 applications per vein (4 in basket, 4 in flower configuration). In recent months we have routinely performed 2 additional ablations in flower configuration with an anterior twist at both right pulmonary veins. All veins were checked for entrance- and exitblock to confirm isolation in sinus rhythm. An additional ablation was performed if necessary. Results In total, 231 patients were analysed. Mean age was 62±10 years, 38% were female. Mean CHADS-VASc score was 2±1. 61% had paroxysmal AF (PAF), 36% persistent AF, and 3% patients had long-standing persistent AF. In 85% (n=197) first-pass isolation of all veins was possible. Primary PV isolation was achieved in all patients at the end of the procedure. In addition to PVI, the cavo-tricuspid isthmus (CTI) was blocked in 6% (using radiofrequency ablation in case of previously or during the procedure documented typical flutter) and the posterior wall was isolated in another 6% during the first procedure. Mean procedure time was 60±20 minutes (24-175 minutes), mean X-ray time 19±9 minutes. In 231 procedures, only two catheter-associated complications were documented. 38 patients (16%) had arrhythmia recurrence after a blanking period of 3 months and a mean follow-up of 273±177 days. Mean time to recurrence was 171±84 days. Women were more likely to have recurrences [OR 2.042 (CI 95% 1.012-4.121), p<0,05]. Patients who had undergone any type of cardiac surgery prior to ablation were also significantly more likely to have recurrence [OR 0.517 (CI 95% 0.116-0.212); p<0.001]. Patients with no other comorbidities were more likely to remain free from arrhythmias [OR 0.792 (95% CI 0.736-0.853); p<0,01]. The type of AF did not make a significant difference according to the risk of recurrence in this cohort. To date, we have performed 18 re-do procedures in patients after PVI with PFA. The recurrent arrhythmia was AF in 39% (n=7), atypical AT in 50% (roof-dependent: 28%, n=5; mitral isthmus dependent: 22%, n=4), and CTI-dependent flutter in 39% (n=7). All but one patient had PV reconnections, and all were successfully reablated. Conclusion PFA success rate is similar to that of thermal techniques. Procedure time is shorter in experienced operators and the complication rate is low in our cohort. Results from RCTs are needed to further evaluate this new method compared to other ablation techniques.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/europace/euae102.813
- https://academic.oup.com/europace/article-pdf/26/Supplement_1/euae102.813/57876313/euae102.813.pdf
- OA Status
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- Related Works
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- OpenAlex ID
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All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4398777613Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/europace/euae102.813Digital Object Identifier
- Title
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Incidence, types, and predictors of AF recurrence after AF ablation with pulsed field ablation. A single-centre experienceWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
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2024-05-01Full publication date if available
- Authors
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A Eberl, Martin Manninger, Ursula Rohrer, A Reischl, Martin Benedikt, Egbert Bisping, P. Lercher, Andreas Zirlik, Douglas S. ScherrList of authors in order
- Landing page
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https://doi.org/10.1093/europace/euae102.813Publisher landing page
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https://academic.oup.com/europace/article-pdf/26/Supplement_1/euae102.813/57876313/euae102.813.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://academic.oup.com/europace/article-pdf/26/Supplement_1/euae102.813/57876313/euae102.813.pdfDirect OA link when available
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Medicine, Ablation, Incidence (geometry), Atrial fibrillation, Cardiology, Internal medicine, Catheter ablation, Optics, PhysicsTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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