Safety and effectiveness of additional left atrial posterior wall ablation using pulsed field ablation for persistent and long-standing persistent atrial fibrillation patients.
J Cardiovasc Electrophysiol
; 35(8): 1525-1535, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38803029
ABSTRACT
INTRODUCTION:
The unique safety profile of pulsed field ablation (PFA) has made pulmonary vein isolation (PVI) + left atrial posterior wall (LAPW) ablation promising for treating persistent atrial fibrillation (PerAF). The goal of this study was to assess long-term freedom from atrial fibrillation, atrial flutter, and atrial tachycardia (AF/AFL/AT), as well as the safety and feasibility of LAPW PFA using multipolar, pentaspline Farawave catheter.METHODS:
Retrospective observational study at a single institution. Data for 94 patients were collected from a prespecified intraprocedural registry. The long-term AF/AFL/AT recurrence assessment was based on an analysis of medical history; 24-h Holter ECGs at 3, 6, and 12 months postablation; and 12-lead ECGs recorded during symptomatic episodes or visits.RESULTS:
Half of the patients had ls-PerAF, and half had a history of catheter ablation-mostly RF PVI. The acute ablation success rate was 100%, and the primary safety outcome was observed in 2 patients. Fifty patients experienced AF/AFL/AT recurrence (54.3%). An increase in LAPW low-voltage areas and AF classification were associated with arrhythmia recurrence. After a median follow-up of 13 months, the KaplanâMeier estimated median time free of AF/AFL/AT after a single procedure was 14.7 months.CONCLUSION:
PFA PVI + PWA had the best outcome in perAF patients without extensive LA fibrosis. AF recurrence was paroxysmal in significant part of the cohort. The addition of PWA to PVI using multipolar PFA was safe and did not significantly influence the transpired ablation time.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Venas Pulmonares
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Recurrencia
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Fibrilación Atrial
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Potenciales de Acción
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Ablación por Catéter
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Frecuencia Cardíaca
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Croacia