Ablation of accessory pathways in different anatomic locations using focal pulsed field ablation.
Heart Rhythm
; 21(8): 1211-1217, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38499129
ABSTRACT
BACKGROUND:
Ablation of accessory pathways (APs) is the cornerstone for treatment of patients with Wolff-Parkinson-White syndrome and manifestation of atrioventricular reentrant tachycardia. Pulsed field ablation (PFA) is a new type of nonthermal energy source delivered to the underlying tissue via the ablation catheter and used for ablation of arrhythmic substrates.OBJECTIVE:
The purpose of this study was to determine the efficiency and long-term outcome of ablation of APs of different localizations using a focal pulsed electrical field.METHODS:
Electrophysiological study was performed in patients with indication for AP ablation. An ablation catheter was used to map the position of AP insertion. Pulsed electric field was delivered through a standard ablation catheter. In left-sided APs, the first ablation attempt was within the coronary sinus (CS). Patient follow-up was scheduled 1-3 months after the ablation. Additional check-up was performed after 6 and 12 months.RESULTS:
Fourteen 14 patients (3 pediatric) were treated. Termination of AP conduction was achieved in all procedures. The cohort consisted of 3 right free wall, 3 posteroseptal, and 8 left-sided APs. Ablation through CS was successfully used in 7 of 8 patients with left-sided APs. No complications were reported. Median follow-up was 5.5 months. Conduction recurrence through AP was documented in 1 patient.CONCLUSION:
Focal PFA for AP shows promising results in terms of efficacy and safety. A high rate of successful termination of left-sided APs by ablation within CS may represent a new standard approach. The safety and efficacy profile of PFA seems to be transferable to the pediatric population.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Wolff-Parkinson-White Syndrome
/
Catheter Ablation
/
Accessory Atrioventricular Bundle
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Heart Rhythm
Year:
2024
Document type:
Article
Country of publication:
Estados Unidos