Circ Arrhythm Electrophysiol
Jessa Ziekenhuis, Hasselt, Belgium (T.P., P.K., N.A., J.V.).
Published: December 2024
Background: Pulsed field ablation (PFA) is a promising treatment for atrial fibrillation. We report 1-year freedom from atrial arrhythmia outcomes using monopolar PFA delivered through 3 commercial, contact force-sensing focal catheters.
Methods: ECLIPSE AF (NCT04523545) was a prospective, single-arm, multicenter study evaluating acute and chronic safety and performance using the CENTAURI system to deliver focal PFA with TactiCath SE, StablePoint, and ThermoCool ST. Patients with paroxysmal or persistent atrial fibrillation underwent pulmonary vein (PV) isolation under deep sedation or general anesthesia and returned for remapping at 90 days to evaluate chronic durability. Freedom from atrial arrhythmia was evaluated continuously through 12 months using standard rhythm monitoring for symptomatic episodes and 24-hour Holter at 6 and 12 months.
Results: Eighty-two patients (74% male, 51.2% paroxysmal, and 58.5% deep sedation) were treated. PV isolation was achieved in 100% of targeted veins (322/322) with first-pass isolation in 92.2% (297/322). There were 4 primary safety events in 4 patients (4.9%, 4/82); 1 nonembolic stroke due to exacerbated cardiac tamponade secondary to catheter perforation and 3 hemorrhagic vascular access complications. There were no incidences of adverse event fistula, diaphragmatic paralysis, MI, pericarditis, thromboembolism, PV stenosis, transient ischemic attack, or death. Eighty patients (98%) underwent remapping. Optimized PFA cohorts 3, 4, and 5 showed per-patient isolation rates of 60%, 73%, and 81% and per-PV isolation rates of 84%, 90%, and 92%, respectively. One-year freedom from atrial arrhythmia was 80.2% (95% CI, 69.7%-87.4%) for the entire patient sample, including 41 patients who underwent repeat focal PFA with the CENTAURI system at remapping.
Conclusions: This study demonstrated that optimization of focal PFA with 3 contact force-sensing, solid-tip ablation catheters resulted in the progressive improvement of PV isolation durability at 3-month remapping and high freedom from atrial arrhythmia survival rates, providing a promising focal PFA treatment option integrated with current ablation workflows.
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http://dx.doi.org/10.1161/CIRCEP.124.012794 | DOI Listing |
Heliyon
January 2025
Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan.
Background: Left atrial low-voltage areas (LVAs) are known to be associated with atrial myopathy and atrial fibrillation (AF) recurrence after catheter ablation. However, the association between body size and prevalence of LVAs has not been fully elucidated. The purpose of this study was to clarify the association between body size and the prevalence of LVAs in patients with AF ablation.
View Article and Find Full Text PDFPacing Clin Electrophysiol
January 2025
Department of Pharmacy, First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Purpose: To optimize the effectiveness and safety of pulmonary vein isolation, pulsed-field ablation (PFA) and high-power short-duration ablation (HPSD) have recently been incorporated into clinical practice. The objective of this study is to conduct a comparative analysis, focusing on the efficacy, safety, and procedural efficiency of PFA and HPSD in the treatment of atrial fibrillation (AF).
Methods: A thorough search was performed across multiple databases to identify trials that compared PFA with HPSD for AF from their inception until July 2024.
J Cardiothorac Surg
January 2025
University of Medicine and Pharmacy - Vietnam National University, Hanoi, Vietnam.
Background: .Endoscopic mitral valve repair has progressively been adopted as the standard approach for treating isolated mitral regurgitation across numerous renowned cardiac surgery centers worldwide. Our innovative method for mitral valve exposure has been previously described.
View Article and Find Full Text PDFArch Cardiovasc Dis
December 2024
Service de cardiologie, hôpital Henri-Mondor, 94000 Créteil, France. Electronic address:
Background: Catheter ablation for atrial fibrillation in patients with heart failure with reduced ejection fraction is associated with a significant reduction in morbimortality. The convergent procedure is a valid ablation option for the treatment of long-standing persistent atrial fibrillation.
Aim: To describe the outcomes of patients with heart failure with reduced ejection fraction and long-standing persistent atrial fibrillation who underwent the convergent procedure.
Cardiovasc Ther
January 2025
Department of Cardiology The Affiliated Hospital of Southwest Jiaotong University The Third People's Hospital of Chengdu Cardiovascular Disease Research Institute of Chengdu, Chengdu, Sichuan, China.
There is limited available data regarding the impact of cycle length (CL) prolongation when converting atrial fibrillation (AF) to organized atrial tachycardia (AT) and its effect on clinical outcomes. We retrospectively screened and included a cohort of 132 patients with persistent or long-standing persistent AF who underwent circumferential pulmonary vein isolation (CPVI) and left atrial substrate modification (LASM) between January 2015 and October 2019. In all 132 consecutive patients, persistent AF was successfully converted into organized AT.
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