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Pulsed field ablation in patients with cardiac implantable electronic devices: an ex vivo assessment of safety.
Lennerz, Carsten; O'Connor, Matthew; Schaarschmidt, Claudia; Reents, Tilko; Bourier, Felix; Telishevska, Marta; Lengauer, Sarah; Popa, Miruna; Wimbauer, Katharina; Holmgren, Ellen; Thoma, Mara; Spitzauer, Lovis; Bahlke, Fabian; Krafft, Hannah; Englert, Florian; Knoll, Katharina; Friedrich, Lena; Blazek, Patrick; Hessling, Gabriele; Kolb, Christof; Deisenhofer, Isabel; Kottmaier, Marc.
Afiliação
  • Lennerz C; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany. lennerz@dhm.mhn.de.
  • O'Connor M; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. lennerz@dhm.mhn.de.
  • Schaarschmidt C; Cardiology Department, Auckland City Hospital, Auckland, New Zealand.
  • Reents T; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Bourier F; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Telishevska M; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Lengauer S; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Popa M; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Wimbauer K; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Holmgren E; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Thoma M; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Spitzauer L; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Bahlke F; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Krafft H; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Englert F; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Knoll K; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Friedrich L; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Blazek P; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
  • Hessling G; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Kolb C; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Deisenhofer I; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
  • Kottmaier M; Department of Electrophysiology, German Heart Centre Munich, Technical University of Munich, Lazarettstr. 36, 80636, Munich, Germany.
Article em En | MEDLINE | ID: mdl-38775921
ABSTRACT

BACKGROUND:

Pulse field ablation (PFA) is a novel catheter ablation technology with potential safety benefits due to its tissue selectivity. It has the potential to directly damage or interact with the functionality of cardiac implantable electronic devices (CIEDs) in the form of electromagnetic interference (EMI). The aim of our study was to assess the impact of PFA on CIEDs.

METHODS:

PFA lesions (45 per CIED) were applied from the Farapulse system to CIEDs (< 5 cm from the lead tip and < 15 cm from the generator). All devices were checked before and after PFA application for proper sensing and pacing functionality as well as for integrity of shock circuits in ICDs using a heart simulator. Moreover, devices were then interrogated for any spontaneous reprogramming, mode switching or other EMI effects.

RESULTS:

In total, 44 CIEDs were tested (16 pacemaker, 21 ICDs, 7 CRT-P/D) with 1980 PFA applications. There was no change in device settings, functionality and electrical parameters, and there was no macroscopic damage to the devices. The risk of damage to the electric components or leads on a patient-based analysis is 0/44 (95% CI 0-8%) and on a PFA pulse-based analysis is 0/1980 (95% CI 0-0.2%). Clinically relevant EMI appeared with oversensing and pacing inhibition but not tachycardia detection.

CONCLUSIONS:

Bipolar PFA appears safe and does not result in damage to CIEDs or leads. Clinically relevant EMI does occur, but appropriate peri-procedural programming may mitigate this. In vivo studies are needed to confirm our findings.
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Texto completo: 1 Bases de dados: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Bases de dados: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Assunto da revista: CARDIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Alemanha