Prospective 1-year results of atrial fibrillation ablation using the pentaspline pulsed field ablation catheter: The initial French experience - 19/04/24
Graphical abstract |
Highlights |
• | Initial French experience of AF ablation using the pentaspline PFA catheter. |
• | First prospective real-world multicentre cohort. |
• | One-year freedom from arrhythmia recurrence was 77.6%. |
• | Rate of major complications was 2.6%. |
• | AF at procedure start independently associated with arrhythmia recurrence. |
• | Adjustment made for type of AF, LA size and rhythm at procedure start. |
• | After adjustment, extra PV PFA applications not associated with better outcome. |
Abstract |
Background |
Pulsed field ablation has recently emerged as an interesting non-thermal energy for atrial fibrillation ablation. At a time of rapid spread of this technology, there is still a lack of prospective real-life data.
Aim |
To describe multicentre prospective safety and 1-year efficacy data in three of the first French centres to use pulsed field ablation.
Methods |
All consecutive patients undergoing a first pulsed field ablation were included prospectively. The primary outcome was freedom from documented atrial arrhythmia. The safety endpoint was a composite of major adverse events. Univariate and multivariable analyses, including patient and procedural characteristics, were performed to identify factors predictive of recurrence.
Results |
Between May 2021 and June 2022, 311 patients were included (paroxysmal atrial fibrillation in 53%, persistent atrial fibrillation in 35% and long-standing persistent atrial fibrillation in 11%). Additional non-pulmonary vein pulsed field ablation applications were performed in 104/311 patients. One-year freedom from arrhythmia recurrence was 77.6% in the overall population and was significantly higher in patients with paroxysmal atrial fibrillation (88.4%) compared with patients with persistent atrial fibrillation (69.7%; P<0.001) and those with long-standing persistent atrial fibrillation (49.0%; P<0.001). The major complication rate was 2.6% (tamponade in four patients, stroke in two patients and coronary spasm in one patient). Besides the usual predictors of recurrences (left atrium size, CHA2DS2-VASc score, type of atrial fibrillation), the presence of atrial fibrillation at procedure start was independently associated with arrhythmia recurrence (hazard ratio: 2.04, 95% confidence interval: 1.10–3.77).
Conclusion |
In this prospective multicentre real-world study, pulsed field ablation for atrial fibrillation ablation seems to be associated with a good safety profile and rather favourable acute and 1-year success rates.
Le texte complet de cet article est disponible en PDF.Keywords : Atrial fibrillation, Catheter ablation, Pulsed field ablation, Pulmonary vein isolation, Arrhythmia
Plan
Vol 117 - N° 4
P. 249-254 - avril 2024 Retour au numéro
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