Early recurrences predict late therapy failure after pulsed field ablation of atrial fibrillation.
J Cardiovasc Electrophysiol
; 34(12): 2425-2433, 2023 Dec.
Article
en En
| MEDLINE
| ID: mdl-37767744
ABSTRACT
INTRODUCTION:
Pulsed field ablation (PFA) is a new ablation technology for atrial fibrillation (AF). Data regarding early recurrences of atrial tachyarrhythmia (ERAT) after PFA-pulmonary vein isolation (PVI) are sparse.METHODS:
Consecutive patients with symptomatic AF were enrolled to undergo PFA-PVI. A dedicated catheter delivering bipolar energy (1.9-2.0 kV) was used. Late recurrence (LR) was defined as documented AF/atrial tachycardia (AT) lasting more than 30 s after a 90-day blanking period.RESULTS:
Two hundred and thirty-one patients (42% female, age 69 ± 12, 55% paroxysmal AF [PAF]) were included in this analysis. Median follow-up time was 367 days (interquartile range 253-400). Forty-six patients (21%) experienced ERAT after a median of 23 days (46% in PAF and 54% in persistent AF [persAF]). Kaplan-Meier estimated freedom of AF/AT was 74.2% at 1 year, 81.8% for PAF, and 64.8% for persAF (p = .0079). Of patients experiencing ERAT, an LR was observed in 54%. There was no significant difference of LR between those who presented with very early ERAT (0-45 days) and those with ERAT (46-90 days) (p = .57). In multivariate analysis, ERAT (hazard ratio [HR] 3.370; 95% confidence interval [95% CI] 1.851-6.136; p < .001) and female sex (HR 2.048; 95% CI 1.114-3.768; p = .021) were the only independent predictors for LR.CONCLUSIONS:
ERAT could be recorded in 21% of patients after PFA-PVI and was an independent predictor for LR. We found no difference in the rate of LRs among patients experiencing ERAT before or after 45 days.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Venas Pulmonares
/
Fibrilación Atrial
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Taquicardia Supraventricular
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Ablación por Catéter
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Cardiovasc Electrophysiol
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
FISIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Alemania