Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Turagam, MK; Neuzil, P; Schmidt, B; Reichlin, T; Neven, K; Metzner, A; Hansen, J; Blaauw, Y; Maury, P; Arentz, T; Sommer, P; Anic, A; Anselme, F; Boveda, S; Deneke, T; Willems, S; van, der, Voort, P; Tilz, R; Funasako, M; Scherr, D; Wakili, R; Steven, D; Kautzner, J; Vijgen, J; Jais, P; Petru, J; Chun, J; Roten, L; Füting, A; Lemoine, MD; Ruwald, M; Mulder, BA; Rollin, A; Lehrmann, H; Fink, T; Jurisic, Z; Chaumont, C; Adelino, R; Nentwich, K; Gunawardene, M; Ouss, A; Heeger, CH; Manninger, M; Bohnen, JE; Sultan, A; Peichl, P; Koopman, P; Derval, N; Kueffer, T; Reinsch, N; Reddy, VY.
Impact of Left Atrial Posterior Wall Ablation During Pulsed-Field Ablation for Persistent Atrial Fibrillation.
JACC Clin Electrophysiol. 2024; 10(5):900-912 Doi: 10.1016/j.jacep.2024.01.017
Web of Science PubMed FullText FullText_MUG

 

Co-authors Med Uni Graz

Manninger-Wünscher Martin

Scherr Daniel

Altmetrics:

Dimensions Citations:

Plum Analytics:

Scite (citation analytics):

Abstract:

BACKGROUND: Pulmonary vein isolation (PVI) alone is insufficient to treat many patients with persistent atrial fibrillation (PersAF). Adjunctive left atrial posterior wall (LAPW) ablation with thermal technologies has revealed lack of efficacy, perhaps limited by the difficulty in achieving lesion durability amid concerns of esophageal injury. OBJECTIVES: This study aims to compare the safety and effectiveness of PVI + LAPW ablation vs PVI in patients with PersAF using pulsed-field ablation (PFA). METHODS: In a retrospective analysis of the MANIFEST-PF (Multi-National Survey on the Methods, Efficacy, and Safety on the Post-approval Clinical Use of Pulsed Field Ablation) registry, we studied consecutive PersAF patients undergoing post-approval treatment with a pentaspline PFA catheter. The primary effectiveness outcome was freedom from any atrial arrhythmia of ≥30 seconds. Safety outcomes included the composite of acute and chronic major adverse events. RESULTS: Of the 547 patients with PersAF who underwent PFA, 131 (24%) received adjunctive LAPW ablation. Compared to PVI-alone, patients receiving adjunctive LAPW ablation were younger (65 vs 67 years of age, P = 0.08), had a lower CHA₂DS₂-VASc score (2.3 ± 1.6 vs 2.6 ± 1.6, P = 0.08), and were more likely to receive electroanatomical mapping (48.1% vs 39.0%, P = 0.07) and intracardiac echocardiography imaging (46.1% vs 17.1%, P < 0.001). The 1-year Kaplan-Meier estimate for freedom from atrial arrhythmias was not statistically different between groups in the full (PVI + LAPW: 66.4%; 95% CI: 57.6%-74.4% vs PVI: 73.1%; 95% CI: 68.5%-77.2%; P = 0.68) and propensity-matched cohorts (PVI + LAPW: 71.7% vs PVI: 68.5%; P = 0.34). There was also no significant difference in major adverse events between the groups (2.2% vs 1.4%, respectively, P = 0.51). CONCLUSIONS: In patients with PersAF undergoing PFA, as compared to PVI-alone, adjunctive LAPW ablation did not improve freedom from atrial arrhythmia at 12 months.

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

Humans - administration & dosage

Atrial Fibrillation - surgery

Male - administration & dosage

Female - administration & dosage

Aged - administration & dosage

Catheter Ablation - methods, adverse effects

Middle Aged - administration & dosage

Retrospective Studies - administration & dosage

Heart Atria - surgery

Pulmonary Veins - surgery

Treatment Outcome - administration & dosage

Registries - administration & dosage

Find related publications in this database (Keywords)

atrial fibrillation

posterior wall ablation

pulmonary vein isolation

pulsed fi eld ablation

© Med Uni Graz • Imprint