Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
33647464
DOI
10.1016/j.hrthm.2021.02.020
PII: S1547-5271(21)00182-X
Knihovny.cz E-zdroje
- Klíčová slova
- Atrial fibrillation, Electroporation, Level of isolation, Pulmonary vein isolation, Pulsed field ablation,
- MeSH
- časové faktory MeSH
- fibrilace síní patofyziologie chirurgie MeSH
- katetrizační ablace metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- prospektivní studie MeSH
- studie proveditelnosti MeSH
- venae pulmonales chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: The tissue specificity of pulsed field ablation (PFA) makes it an attractive energy source for pulmonary vein (PV) isolation (PVI). However, beyond each PFA lesion's zone of irreversible electroporation and cell death, there may be a surrounding zone of reversible electroporation and cell injury that could potentially normalize with time. OBJECTIVE: The purpose of this study was to assess whether the level of electrical PVI that is observed acutely after PFA regresses over time. METHODS: In a clinical trial, patients with paroxysmal atrial fibrillation underwent PVI using a biphasic PFA waveform delivered through a dedicated, variably deployable multielectrode basket/flower catheter. Detailed voltage maps were created using a multispline diagnostic catheter immediately after PFA and again ∼3 months later in a prospective, protocol-specified reassessment procedure. We analyzed 20 patients who underwent PFA with durable PVI and available maps from both time points. To compare the ablated zones, the left- and right-sided PV antral isolation areas and nonablated posterior wall area were quantified and the distances between left and right PV low-voltage edges were measured. RESULTS: A comparison of voltage maps immediately after PFA and at a median of 84 days (interquartile range 69-90 days) later revealed that there was no significant difference in either the left- and right-sided PV antral isolation areas or nonablated posterior wall area. The distances between low-voltage edges on the posterior wall were also not significantly different between the 2 time points. CONCLUSION: This study demonstrates that the level of PV antral isolation after PFA with a multielectrode PFA catheter persists without regression.
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