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SHR Neuro Cancer Cardio Lipid Metab Microb

Magni, FT; Scherr, D; Manninger, M; Sohns, C; Sommer, P; Hovakimyan, T; Blaauw, Y; Mulder, BA.
Electrophysiological findings during re-do procedures after single-shot pulmonary vein isolation for atrial fibrillation with pulsed field ablation.
J Interv Card Electrophysiol. 2023; 66(7):1729-1737 Doi: 10.1007/s10840-023-01559-z [OPEN ACCESS]
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Leading authors Med Uni Graz

Scherr Daniel

Co-authors Med Uni Graz

Manninger-Wünscher Martin

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Abstract:

BACKGROUND: Pulsed field ablation (PFA) is a novel ablation technology recently adopted in the treatment of atrial fibrillation (AF). Currently, little is known about the durability of PFA ablation lesions. METHODS: We investigated patients who underwent redo-ablation due to recurrent AF/atrial-flutter or tachycardia (AFL/AT) following PVI with PFA. We report electrophysiological findings and ablation strategy during redo-ablation. RESULTS: Of 447 patients undergoing index PVI with PFA, 14 patients (age: 61.9±10.8 years; 7 (50.0%) males; left atrial volume index (n=10): 39.4±14.6 mL/m²) were referred for redo-ablation. Initial indication was paroxysmal-AF in 7 patients, persistent-AF in 6 and long-standing-persistent-AF in one patient. Mean time-to-recurrence was 4.9±1.9 months. Three patients received additional posterior-wall-isolation during index PFA. Twelve (85.7%) patients suffered AF recurrence and 5/12 had concomitant AFL. In the remaining 2 patients, one had a (box-dependent) AFL, and one had an atypical AT. No patients had all PVs reconnected. Reconnection in zero, one, two or three PVs was found in 35.7%, 21.4%, 14.3%, and 28.6% of patients, respectively. All 7 patients with zero or one reconnection with AF recurrence received additional/repeat posterior-wall-isolation during re-ablation, while in the others, PVs were re-isolated. Patients with only AFL/AT had no reconnection of PVs, and the substrate was successfully ablated. CONCLUSIONS: Durable PVI (all PV's isolated) was observed in over one-third of patients at re-do. The predominant recurrent arrhythmia following PVI-only was AF. Concomitant (35.7%) or isolated (14.3%) AFL/AT recurrence was observed in 50% of patients.

Find related publications in this database (using NLM MeSH Indexing)

Male - administration & dosage

Humans - administration & dosage

Middle Aged - administration & dosage

Aged - administration & dosage

Female - administration & dosage

Atrial Fibrillation - diagnostic imaging, surgery

Pulmonary Veins - surgery

Heart Atria - surgery

Atrial Flutter - surgery

Cardiac Electrophysiology - administration & dosage

Catheter Ablation - methods

Recurrence - administration & dosage

Treatment Outcome - administration & dosage

Find related publications in this database (Keywords)

Atrial fibrillation

Pulmonary vein isolation

Pulsed field ablation

Repeat ablation

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