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How does the level of pulmonary venous isolation compare between pulsed field ablation and thermal energy ablation (radiofrequency, cryo, or laser)
I. Kawamura, P. Neuzil, P. Shivamurthy, K. Kuroki, J. Lam, D. Musikantow, E. Chu, MK. Turagam, K. Minami, M. Funasako, J. Petru, S. Choudry, MA. Miller, MN. Langan, W. Whang, SR. Dukkipati, JS. Koruth, VY. Reddy
Language English Country Great Britain
Document type Clinical Trial, Journal Article
NLK
Free Medical Journals
from 1999 to 1 year ago
PubMed Central
from 2008
Open Access Digital Library
from 1999-01-01
Medline Complete (EBSCOhost)
from 1999-01-01
Oxford Journals Open Access Collection
from 1999-01-01
- MeSH
- Atrial Fibrillation * diagnosis surgery MeSH
- Catheter Ablation * methods MeSH
- Cryosurgery MeSH
- Laser Therapy MeSH
- Humans MeSH
- Radiofrequency Ablation MeSH
- Recurrence MeSH
- Retrospective Studies MeSH
- Pulmonary Veins * surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
AIMS: We studied the extent/area of electrical pulmonary vein isolation (PVI) after either pulsed field ablation (PFA) using a pentaspline catheter or thermal ablation technologies. METHODS AND RESULTS: In a clinical trial (NCT03714178), paroxysmal atrial fibrillation (PAF) patients underwent PVI with a multi-electrode pentaspline PFA catheter using a biphasic waveform, and after 75 days, detailed voltage maps were created during protocol-specified remapping studies. Comparative voltage mapping data were retrospectively collected from consecutive PAF patients who (i) underwent PVI using thermal energy, (ii) underwent reablation for recurrence, and (iii) had durably isolated PVs. The left and right PV antral isolation areas and non-ablated posterior wall were quantified. There were 20 patients with durable PVI in the PFA cohort, and 39 in the thermal ablation cohort [29 radiofrequency ablation (RFA), 6 cryoballoon, and 4 visually guided laser balloon]. Pulsed field ablation patients were younger with shorter follow-up. Left atrial diameter and ventricular systolic function were preserved in both cohorts. There was no significant difference between the PFA and thermal ablation cohorts in either the left- and right-sided PV isolation areas, or the non-ablated posterior wall area. The right superior PV isolation area was smaller with PFA than RFA, but this disappeared after propensity score matching. Notch-like normal voltage areas were seen at the posterior aspect of the carina in the balloon sub-cohort, but not the PFA or RFA cohorts. CONCLUSION: Catheter-based PVI with the pentaspline PFA catheter creates chronic PV antral isolation areas as encompassing as thermal energy ablation.
References provided by Crossref.org
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