Pulmonary vein isolation durability and lesion regression in patients with recurrent arrhythmia after pulsed-field ablation.

Kueffer, Thomas; Stefanova, Anita; Madaffari, Antonio; Seiler, Jens; Thalmann, Gregor; Kozhuharov, Nikola; Maurhofer, Jens; Galuszka, Oskar; Haeberlin, Andreas; Noti, Fabian; Servatius, Helge; Tanner, Hildegard; Roten, Laurent; Reichlin, Tobias (2023). Pulmonary vein isolation durability and lesion regression in patients with recurrent arrhythmia after pulsed-field ablation. (In Press). Journal of interventional cardiac electrophysiology Springer 10.1007/s10840-023-01608-7

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BACKGROUND

A novel multipolar pulsed-field ablation (PFA) catheter has recently been introduced for pulmonary vein isolation (PVI). Pre-market data showed high rates for PVI-durability during mandatory remapping studies.

OBJECTIVE

To present post-market data in patients with recurrent arrhythmias.

METHODS

Consecutive patients undergoing a redo procedure after an index PFA PVI using a bipolar-biphasic PFA system were included. 3-D electro-anatomical maps (3D-EAM) on redo procedure were compared to the 3D-EAM acquired after ablation during the index procedure. PVI durability was assessed on a per-vein and per-patient level and the sites of reconnections were identified. Furthermore, lesion extent around veins with durable isolation was compared to study lesion regression.

RESULTS

Of 341 patients treated with a PFA PVI, 29 (8.5%) underwent a left atrial redo ablation due to arrhythmia recurrence. At the end of the index procedure, 110/112 veins (98%, four common ostia) were isolated. On redo procedures performed a median of 6 months after the first ablation, 3D-EAM identified 69/110 (63%) PVs with durable isolation. In 6 (21%) patients, all PVs were durably isolated. Reconnections were more often found on the right-sided veins and on the anterior aspects of the upper veins. Only minor lesion regression was observed between the index and redo procedure (a median of 3 mm (0 - 9.5) on the posterior wall).

CONCLUSION

In patients with arrhythmia recurrence after PFA PVI using a first-generation PFA device, durable isolation was observed in 63% of the veins and 21% of the patients showed durable isolation of all previously isolated veins.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Musculoskeletal Biomechanics
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Kueffer, Thomas, Stefanova, Anita, Madaffari, Antonio, Seiler, Jens, Thalmann, Gregor, Kozhuharov, Nikola Asenov, Maurhofer, Jens Rudolf, Galuszka, Oskar Marian, Häberlin, Andreas David Heinrich, Noti, Fabian, Servatius, Helge Simon (B), Tanner, Hildegard, Roten, Laurent, Reichlin, Tobias Roman

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1572-8595

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

02 Aug 2023 10:49

Last Modified:

03 Aug 2023 09:49

Publisher DOI:

10.1007/s10840-023-01608-7

PubMed ID:

37523023

Uncontrolled Keywords:

Atrial fibrillation Pulmonary Vein isolation Pulsed-field ablation Reconnection

BORIS DOI:

10.48350/185167

URI:

https://boris.unibe.ch/id/eprint/185167

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