Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Reischl, A.
Patients with atrial fibrillation undergoing catheter ablation with innovative therapies – a single center experience
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 53
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Rohrer Ursula
- Scherr Daniel
- Altmetrics:
- Abstract:
- Background: Atrial fibrillation (AF) remains the most common tachyarrhythmia in adults. The morbidity and mortality in patients with AF are much higher compared to patients in sinus rhythm. There are already various treatment options for restoring sinus rhythm, but catheter ablation offers the best chance of lasting success. Most established energy sources for pulmonary vein isolation (PVI) such as radiofrequency and cryoablation have their limitations concerning efficacy and safety. New ablation techniques are constantly being developed with the goal of improving safety and efficacy. Pulsed field ablation (PFA) is a non-thermal technique generating short, high-energy electrical pulses using irreversible electroporation and thus has the potential to improve ablation success and reduce complications of PVI. Method: All patients that underwent a PFA-PVI at the Department of Cardiology of the Medical University of Graz were retrospectively analyzed. The statistical analysis was performed using Excel and SPSS. Results: 155 patients were included in the analysis (39% female, 62±9 years). Two-thirds of the patients had paroxysmal atrial fibrillation and 6% of all patients were additionally diagnosed with atrial flutter. First-pass isolation was achieved in 83% of all patients. 17% of the patients received a touch-up ablation because of gaps, mainly in the region of the left superior pulmonary vein. Ablation procedure time was 76±30min and 118±27min when additionally, ablation for atrial flutter was performed. 79% of patients were free of recurrence of any atrial arrhythmia at the one year follow up. Recurrence occurred in 21% of patients after 77±91 days with 10 patients undergoing a redo procedure within the first year. Most commonly gaps of the right inferior pulmonary vein and in the ridge area of the left pulmonary veins as well as in the area of the carinae was observed. No major complication occurred. Conclusion: Pulsed field ablation represents a new non-thermal ablation technique with promising success rates and low complication rates. However, there is a need for prospective multicenter studies with high case numbers to draw better conclusions regarding the safety and efficacy of pulsed field ablation.