Pulsed Field Ablation in the Elderly via a Pentaspline Multielectrode Catheter: Safety, Efficacy, and Comparison with Cryoballoon and Radiofrequency Devices.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart rhythm Pub Date : 2025-01-24 DOI:10.1016/j.hrthm.2025.01.025

Kazutaka Nakasone, Domenico G Della Rocca, Michele Magnocavallo, Andres Betancur, Giampaolo Vetta, Luigi Pannone, Antonio Sorgente, Charles Audiat, Jesus Rodriguez, Ioannis Doundoulakis, Andrija Nekic, Vedran Velagić, Marco Polselli, Sanghamitra Mohanty, Lorenzo Marcon, Juan Sieira, Erwin Ströker, Gezim Bala, Stefano Bianchi, Alexandre Almorad, Stephane Combes, Dimitrios Tsiachris, Andrea Sarkozy, Andrea Natale, Serge Boveda, Pietro Rossi, Carlo de Asmundis, Gian-Battista Chierchia

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引用次数: 0

Abstract

Background: Catheter ablation is an effective treatment for atrial fibrillation (AF). Pulsed field ablation (PFA) has emerged as a novel energy modality, which relies on high-voltage electric fields to achieve cardiac tissue ablation. Data on its efficacy in the elderly are scarce.

Objective: To evaluate the procedural details and clinical outcomes of PFA in patients > 75 years old.

Methods: Consecutive AF patients > 75 years old undergoing PFA via the Farapulse^TM system were enrolled at 6 high-volume centers. Procedural details and clinical outcomes were compared with those of patients undergoing second-generation cryoballoon (CBA) and radiofrequency (RFA) ablation.

Results: Among 983 patients, 221 underwent PFA, 216 CBA, and 546 RFA. Procedure times were shorter with PFA (72 ± 30 minutes) compared to CBA (77 ± 27 minutes) and RFA (99 ± 23 minutes) (p<0.001). Extra-PV ablation was performed in 74.2% PFA, 9.7% CBA, and 42.1% RFA (p<0.001). The major complication rate was 1.01% (n=10) and was not significantly different among groups (1 PFA, 2 CBA, and 7 RFA; p=0.578). Minor complications were observed in 1.4 % PFA, 5.1 % CBA, and 3.5 % RFA (p=0.093). The 1-year atrial tachyarrhythmia freedom in the propensity matched population was 77.2 % with PFA, 80.8 % with CBA, and 74.9 % with RFA) (p=0.52).

Conclusions: PFA was a safe and effective option for elderly patients, offering the advantage of enabling extra-PV ablation without the concern of thermal injury risk.

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.