Redo ablation procedures to treat recurrent atrial arrhythmias via a pentaspline pulsed field ablation catheter: a prospective, multicenter experience

被引：0

作者：

Cespon-Fernandez, Maria ^{[1
]}

Della Rocca, Domenico G. ^{[1
,2
,3
]}

Magnocavallo, Michele ^{[4
]}

Betancur, Andres ^{[5
]}

Lombardo, Ilenia ^{[1
]}

Pannone, Luigi ^{[1
]}

Vetta, Giampaolo ^{[1
]}

Sorgente, Antonio ^{[1
]}

Polselli, Marco ^{[4
]}

Audiat, Charles ^{[1
]}

del Monte, Alvise ^{[1
]}

Combes, Stephane ^{[5
]}

Marcon, Lorenzo ^{[1
]}

Overeinder, Ingrid ^{[1
]}

Nakasone, Kazutaka ^{[1
]}

Mouram, Sahar ^{[1
]}

Mohanty, Sanghamitra ^{[2
]}

Bianchi, Stefano ^{[4
]}

Almorad, Alexandre ^{[1
]}

Sieira, Juan ^{[1
]}

Bala, Gezim ^{[1
]}

Stroker, Erwin ^{[1
]}

Rossi, Pietro ^{[4
]}

Sarkozy, Andrea ^{[1
]}

Boveda, Serge ^{[5
]}

Natale, Andrea ^{[2
]}

de Asmundis, Carlo ^{[1
]}

Chierchia, Gian-Battista ^{[1
]}

HRMC Investigators, Ioannis

机构：

[1] Univ Ziekenhuis Brussel, Heart Rhythm Management Ctr, Brussels, Belgium

[2] Texas Cardiac Arrhythmia Inst, St Davids Med Ctr, Austin, TX 78705 USA

[3] Univ Libre Bruxelles, Dept Cardiol, CHU Brugmann, Brussels, Belgium

[4] Hosp Isola Tiberina Gemelli Isola, Arrhythmol Unit, Rome, Italy

[5] Clin Pasteur, Heart Rhythm Management Dept, Toulouse, France

来源：

JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY | 2025年

关键词：

Pulsed field ablation; Redo ablation; Atrial fibrillation; Posterior wall; Atrio-esophageal fistula; Tissue selectivity; PULMONARY VEIN ISOLATION;

D O I：

10.1007/s10840-025-02021-y

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundPatients undergoing atrial fibrillation (AF) catheter ablation may require redo procedures involving pulmonary vein (PV) re-isolation and/or ablation of extra-PV sites. Pulsed field ablation (PFA) offers a highly selective energy source for cardiac tissue, with the potential to reduce collateral damage to adjacent structures. This study aimed to evaluate the feasibility and efficacy of redo ablation using a pentaspline PFA system.MethodsPatients undergoing redo procedures with a pentaspline PFA system at three international centers were enrolled. A workflow was established based on rhythm at presentation: sinus rhythm (Group 1), atrial flutter/atrial tachycardia (Group 2), or AF (Group 3). Propensity score matching was used for comparison between PFA- and RF-based redo ablations.ResultsA total of 117 patients were included (Group 1: 64, Group 2: 18, Group 3: 35). PV re-isolation was required in 71.9% and 72.2% of Group 1 and 2 patients, respectively. PFA terminated all cases of non-cavotricuspid isthmus dependent flutter and 45.7% of cases of AF. One major complication (0.9%; frontal cerebral hematoma) was documented. Freedom from atrial tachyarrhythmias at 12 months was 78.3% (95% CI 69.6-84.8%) without statistically significant differences among groups (Group 1: 85.7%; Group 2: 77%; Group 3: 65.5%; p = 0.053). PFA led to similar arrhythmia freedom compared to RF, but with significantly shorter procedural and dwelling times.ConclusionThe adoption of a pentaspline PFA system for repeat ablation procedures was feasible, safe, and effective at 1-year follow-up. No clinical differences were observed between PFA and RF; however, redo PFA cases were significantly shorter.

引用

页数：15

共 27 条

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