Pulsed-field- vs. cryoballoon-based pulmonary vein isolation: lessons from repeat procedures.
Europace
; 26(9)2024 Aug 30.
Article
en En
| MEDLINE
| ID: mdl-39166530
ABSTRACT
AIMS:
Pulsed-field ablation (PFA) is an emerging technology to perform pulmonary vein isolation (PVI). Initial data demonstrated high safety and efficacy. Data on long-term PVI durability and reconduction patterns in comparison to established energy sources for PVI are scarce. We compare findings in repeat ablation procedures after a first PFA to findings in repeat ablation procedures after a first cryoballoon ablation (CBA) based PVI. METHODS ANDRESULT:
A total of 550 consecutively enrolled patients underwent PFA or CBA index PVI. Repeat ablations in patients with symptomatic atrial arrhythmia recurrences were analysed. A total of 22/191 (12%) patients after index PFA-PVI and 44/359 (12%) after CBA-PVI underwent repeat ablation. Reconduction of any pulmonary vein (PV) was detected by multipolar spiral mapping catheter at each PV with careful evaluation of PV potentials and by 3D-mapping in 16/22 patients (73%) after PFA-PVI and in 33/44 (75%) after CBA-PVI (P = 1.000). Of 82 initially isolated PVs after PFA-PVI, 31 (38%) were reconducting; of 169 isolated PVs after CBA-PVI, 63 (37%) were reconducting (P = 0.936). Clinical atrial tachycardia occurred similarly in patients after PFA (5/22; 23%) and CBA (7/44; 16%; P = 0.515). Roof lines were set more often after PFA- (8/22; 36%) compared with CBA-PVI (5/44; 11%; P = 0.023). Repeat procedure duration [PFA 87 (76, 123) min; CBA 93 (75, 128) min; P = 0.446] was similar and fluoroscopy time [PFA 11 (9, 14) min; CBA 11 (8, 14) min; P = 0.739] equal between groups at repeat ablation.CONCLUSION:
During repeat ablation after previous PFA- or CBA-based PVI, electrical PV-reconduction rates and patterns were similar.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Venas Pulmonares
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Recurrencia
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Reoperación
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Fibrilación Atrial
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Criocirugía
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:
Europace
Asunto de la revista:
CARDIOLOGIA
/
FISIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Alemania