Beney, Jennifer; Galea, Roberto; Siontis, Georgios; Gräni, Christoph; Kueffer, Thomas; Brugger, Nicolas; Reichlin, Tobias; Räber, Lorenz; Roten, Laurent (2024). Feasibility Study on Atrial Fibrillation Ablation with Pulsed Field Ablation and concomitant Occlusion of the Left Atrial Appendage. Europace, 26(7) Oxford University Press 10.1093/europace/euae176
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BACKGROUND AND AIMS
Atrial fibrillation (AF) ablation and left atrial appendage occlusion (LAAO) are increasingly performed as individual procedures. Pulsed field ablation (PFA) has significantly reduced procedure duration and may be advantageous for the combined approach.
METHODS
We have launched a program for simultaneous AF ablation using PFA and LAAO for patients qualifying for both treatments and excluding those with complex anatomy. We compare procedure duration and fluoroscopy time against individual procedures (either AF ablation or LAAO alone), all performed by the same operators and using consistent technologies.
RESULTS
We performed the combined procedure in 10 patients (50% male; median age 70 years) and excluded two patients (17%) because of complex LAA anatomy. No death, stroke or major bleeding, including pericardial effusion, occurred. For single procedure comparison, 207 AF ablation procedures and 61 LAAO procedures were available. Total median procedure duration was 79 minutes (range 60; 125) for the combined procedure, 71 minutes (25; 241) for individual AF ablation (51 minutes without and 78 minutes with 3D electroanatomic mapping) and 47 minutes (15; 162) for individual LAAO. Respective fluoroscopy times were 21 (15; 26), 15 (5; 44) and 10 (3; 50) minutes. For the combined procedure, femoral vein access to last PFA application lasted 49 minutes (34; 93) and LAAO added 20 minutes (15; 37).
CONCLUSION
Simultaneous PFA-based AF ablation and LAAO in carefully selected patients is feasible, safe, and can be executed within a short overall procedure duration.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Galea, Roberto, Siontis, Georgios, Gräni, Christoph, Kueffer, Thomas, Brugger, Nicolas Jacques, Reichlin, Tobias Roman, Räber, Lorenz, Roten, Laurent |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1532-2092 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
26 Jun 2024 14:50 |
Last Modified: |
13 Jul 2024 00:15 |
Publisher DOI: |
10.1093/europace/euae176 |
PubMed ID: |
38917059 |
Uncontrolled Keywords: |
Atrial fibrillation Catheter ablation Left atrial appendage occlusion Pulmonary vein isolation Pulsed field ablation |
BORIS DOI: |
10.48350/198102 |
URI: |
https://boris.unibe.ch/id/eprint/198102 |
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