Application of a circular-shaped pulsed field ablation catheter with magnetic sensors for pulmonary vein isolation : a multi-centre clinical study report

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology..

AIMS: A few studies have reported the effect and safety of pulsed field ablation (PFA) catheters for ablating atrial fibrillation (AF), which were mainly based on basket-shaped or flower-shaped designs. However, the clinical application of a circular-shaped multi-electrode catheter with magnetic sensors is very limited. To study the efficacy and safety of a PFA system in patients with paroxysmal AF using a circular-shaped multi-electrode catheter equipped with magnetic sensors for pulmonary vein isolation (PVI).

METHODS AND RESULTS: A novel proprietary bipolar PFA system was used for PVI, which utilized a circular-shaped multi-electrode catheter with magnetic sensors and allowed for three-dimensional model reconstruction, mapping, and ablation in one map. To evaluate the efficacy, efficiency, and safety of this PFA system, a prospective, multi-centre, single-armed, pre-market clinical study was performed. From July 2021 to December 2022, 151 patients with paroxysmal AF were included and underwent PVI. The study examined procedure time, immediate success rate, procedural success rate at 12 months, and relevant complications. In all 151 patients, all the pulmonary veins were acutely isolated using the studied system. Pulsed field ablation delivery was 78.4 ± 41.8 times and 31.3 ± 16.7 ms per patient. Skin-to-skin procedure time was 74.2 ± 29.8 min, and fluoroscopy time was 13.1 ± 7.6 min. The initial 11 (7.2%) cases underwent procedures with deep sedation anaesthesia, and the following cases underwent local anaesthesia. In the initial 11 cases, 4 cases (36.4%) presented transient vagal responses, and the rest were all successfully preventatively treated with atropine injection and rapid fluid infusion. No severe complications were found during or after the procedure. During follow-up, 3 cases experienced atrial flutter, and 11 cases had AF recurrence. The estimated 12-month Kaplan-Meier of freedom from arrhythmia was 88.4%.

CONCLUSION: The PFA system, comprised of a circular PFA catheter with magnetic sensors, could rapidly achieve PVI under three-dimensional guidance and demonstrated excellent safety with comparable effects.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 26(2024), 4 vom: 30. März

Sprache:

Englisch

Beteiligte Personen:

Wang, Yan [VerfasserIn]
Lai, Heng Li [VerfasserIn]
Chen, Qi [VerfasserIn]
Liu, Hao [VerfasserIn]
Liu, Qi Ming [VerfasserIn]
Huang, Wei Bin [VerfasserIn]
Tao, Yu [VerfasserIn]
Xiong, Qingmei [VerfasserIn]
Zhou, Ning [VerfasserIn]
Zhao, Chunxia [VerfasserIn]
Qiu, Jie [VerfasserIn]
Xu, Ziqin [VerfasserIn]
Wang, Dao Wen [VerfasserIn]

Links:

Volltext

Themen:

Atrial fibrillation
Catheter ablation
Electroporation
Journal Article
Multicenter Study
Pulmonary vein isolation
Pulsed field ablation

Anmerkungen:

Date Completed 09.04.2024

Date Revised 26.04.2024

published: Print

Citation Status MEDLINE

doi:

10.1093/europace/euae068

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370738039