Kueffer, Thomas; Baldinger, Samuel H; Servatius, Helge; Madaffari, Antonio; Seiler, Jens; Mühl, Aline; Franzeck, Florian; Thalmann, Gregor; Asatryan, Babken; Haeberlin, Andreas; Noti, Fabian; Tanner, Hildegard; Roten, Laurent; Reichlin, Tobias (2022). Validation of a multipolar pulsed-field ablation catheter for endpoint assessment in pulmonary vein isolation procedures. Europace, 24(8), pp. 1248-1255. Oxford University Press 10.1093/europace/euac044
Full text not available from this repository. (Request a copy)AIMS
To validate the performance of a multipolar pulsed-field ablation (PFA) catheter compared to a standard pentaspline 3D-mapping catheter for endpoint assessment of pulmonary vein isolation (PVI). PFA for PVI using single-shot devices combines the benefits of high procedural efficacy and safety. A newly available multipolar PFA catheter allows real-time recording of pulmonary vein (PV) signals during PVI.
METHODS AND RESULTS
Patients undergoing first PVI using PFA with the standard ablation protocol (eight applications per PV) were studied. Entrance and exit block (10 V/2 ms) were assessed using the PFA catheter. Subsequently, a high-density 3D electroanatomical bipolar voltage map (3D-EAM) was constructed using a standard pentaspline 3D-mapping catheter. Additional PFA applications were delivered only after confirmation of residual PV connection by 3D-EAM. In 56 patients, 213 PVs were targeted for ablation. Acute PVI was achieved in 100% of PVs: in 199/213 (93%) PVs with the standard ablation protocol alone and in the remaining 14 PVs after additional PFA applications. The accuracy of PV assessment with the PFA catheter after the standard ablation protocol was 91% (194/213 veins). In 5/213 (2.3%) PVs, the PFA catheter incorrectly indicated PV-isolation. In 14/213 (6.6%), the PFA catheter incorrectly indicated residual PV-conduction due to high-output pace-capture. Lowering the output to 5 V/1 ms reduced this observation to 0.9% (2/213) and increased the overall accuracy to 97% (206/213).
CONCLUSION
A novel multipolar PFA catheter allows reliable endpoint assessment for PVI. Due to its design, far-field sensing and high-output pace-capture can occur. Lowering the pacing output increases the accuracy from 91 to 97%.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Kueffer, Thomas, Baldinger, Samuel Hannes, Servatius, Helge Simon (B), Madaffari, Antonio, Seiler, Jens, Mühl, Aline, Franzeck, Florian Markus, Thalmann, Gregor, Asatryan, Babken, Häberlin, Andreas David Heinrich, Noti, Fabian, Tanner, Hildegard, Roten, Laurent, Reichlin, Tobias Roman |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1099-5129 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
15 Jun 2022 09:24 |
Last Modified: |
29 Mar 2023 23:38 |
Publisher DOI: |
10.1093/europace/euac044 |
PubMed ID: |
35699395 |
Uncontrolled Keywords: |
Atrial fibrillation Exit block Irreversible electroporation Pulmonary vein isolation Pulsed-field ablation |
URI: |
https://boris.unibe.ch/id/eprint/170667 |
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