AIMS: The feasibility and safety of the lattice-tip catheter for ventricular arrhythmia (VA) ablation in humans remain largely unknown. This study aimed to assess feasibility, safety profile as well as patient outcomes after VA ablation with a lattice-tip catheter in a multicentre European registry. METHODS AND RESULTS: All 18 European centres using the AFFERA system in September 2024 agreed to participate. Clinical, procedural, and follow-up data (minimum 3 months) were systematically collected and analysed. A total of 126 patients (18% female; mean age 59 ± 16 years) underwent VA ablation using the lattice-tip catheter during the inclusion period. Ablation indications included ventricular tachycardia (VT) in 99, premature ventricular complexes (PVCs) in 23, and ventricular fibrillation (VF) in 4 patients. Major and minor acute complications were observed in 7 (6%) and 18 (14%) procedures, respectively. They included thrombo-embolic event (n = 2), major bleeding (n = 2), ventricular fibrillation induction (n = 1), tamponade due to epicardial access (n = 1), and cardiogenic shock due to prolonged VT mapping (n = 1). Within the first month post-procedure, three patients died [from multi-organ failure (n = 2) and sepsis (n = 1)], two had worsening heart failure, one myocardial infarction, one sepsis, and one major gastro-intestinal bleeding. After a mean follow-up of 5.6 ± 3.7 months, absence of recurrence was 78% for PVC, 70% for VT, and 100% for VF. CONCLUSION: In this complex population with refractory VA, ablation using the lattice-tip catheter appears feasible and relatively safe. In the absence of large, randomized trials, exhaustive registry is of key importance to ensure safety and efficacy of new catheter technologies.

Cardiac Arrhythmia Department IHU Liryc Univ Bordeaux INSERM 1045 CHU de Bordeaux CMARY ERN Guard Heart REFER RYTHMO Network F33600 Bordeaux France

Cardioangiologische Centrum Bethanien Frankfurt Germany

Cardiovascular Institute Paris Sud Jacques Cartier Private Hospital Massy France

Department of Arrhythmology Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Cardiac Electrophysiology Inselspital University of Bern Bern Switzerland

Department of Cardiology Na Homolce Hospital Prague Czech Republic

Department of Cardiology Ordensklinikum Linz Elisabethinen Linz Austria

Department of Cardiology University Heart and Vascular Center Hamburg University Medical Center Hamburg Eppendorf Hamburg Germany

Department of Electrophysiology and Pacing Onassis Cardiac Surgery Center Athens Greece

Department of Medicine University of Cambridge Cambridge UK

Department of Pacing and Electrophysiology Beacon Hospital Dublin Ireland

Electrophysiology Department Royal Papworth Hospital NHS Foundation Trust Cambridge UK

Electrophysiology Unit Cardiology Service Hospital Puerta de Hierro Majadahonda Madrid Spain

General and Interventional Cardiology Rhythmology Clinic Pasteur Toulouse France

Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel Vrije Universiteit Brussel European Reference Networks Guard Heart Brussels Belgium

Imperial College London London UK

Servicio de Cardiología Hospital General Universitario Gregorio Marañón Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares Madrid Spain

Europace. 2025 Sep 1;27(9):euaf161. doi: 10.1093/europace/euaf161. PubMed

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