Early recurrences predict late therapy failure after pulsed field ablation of atrial fibrillation.

Introduction: Pulsed field ablation (PFA) is a new ablation technology for atrial fibrillation (AF). Data regarding early recurrences of atrial tachyarrhythmia (ERAT) after PFA‐pulmonary vein isolation (PVI) are sparse. Methods: Consecutive patients with symptomatic AF were enrolled to undergo PFA‐P...

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Published in:Journal of Cardiovascular Electrophysiology Vol. 34; no. 12; pp. 2425 - 2434
Main Authors: Plank, Karin, Bordignon, Stefano, Urbanek, Lukas, Chen, Shaojie, Tohoku, Shota, Schaack, David, Hirokami, Jun, Efe, Tolga, Chun, K.R. Julian, Schmidt, Boris
Format: diagnostic images research tables/charts tracings Journal Article
Published: Wiley-Blackwell Dec2023
Online Access:View this record in EBSCOhost
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      jtl: Journal of Cardiovascular Electrophysiology
      issn: 10453873
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    pubinfo:
      dt: Dec2023
      vid: 34
      iid: 12
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/jce.16083
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        atl: Early recurrences predict late therapy failure after pulsed field ablation of atrial fibrillation.
      aug:
        au:
          Plank, Karin
          Bordignon, Stefano
          Urbanek, Lukas
          Chen, Shaojie
          Tohoku, Shota
          Schaack, David
          Hirokami, Jun
          Efe, Tolga
          Chun, K.R. Julian
          Schmidt, Boris
        affil: Cardioangiologisches Centrum Bethanien CCB at Agaplesion Markus Krankenhaus, Medizinische Klinik III, Frankfurt am Main, Germany
      sug:
        subj:
          Atrial Fibrillation Surgery
          Recurrence Risk Factors
          Treatment Failure
          Tachycardia, Atrial
          Treatment Outcomes Evaluation
          Catheter Ablation Methods
          Risk Assessment
          Human
          Female
          Male
          Middle Age
          Aged
          Aged, 80 and Over
          Time Factors
          Kaplan-Meier Estimator
          Multivariate Analysis
          Confidence Intervals
          Sex Factors
          After Care
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Introduction: Pulsed field ablation (PFA) is a new ablation technology for atrial fibrillation (AF). Data regarding early recurrences of atrial tachyarrhythmia (ERAT) after PFA‐pulmonary vein isolation (PVI) are sparse. Methods: Consecutive patients with symptomatic AF were enrolled to undergo PFA‐PVI. A dedicated catheter delivering bipolar energy (1.9–2.0 kV) was used. Late recurrence (LR) was defined as documented AF/atrial tachycardia (AT) lasting more than 30 s after a 90‐day blanking period. Results: Two hundred and thirty‐one patients (42% female, age 69 ± 12, 55% paroxysmal AF [PAF]) were included in this analysis. Median follow‐up time was 367 days (interquartile range: 253–400). Forty‐six patients (21%) experienced ERAT after a median of 23 days (46% in PAF and 54% in persistent AF [persAF]). Kaplan–Meier estimated freedom of AF/AT was 74.2% at 1 year, 81.8% for PAF, and 64.8% for persAF (p =.0079). Of patients experiencing ERAT, an LR was observed in 54%. There was no significant difference of LR between those who presented with very early ERAT (0–45 days) and those with ERAT (46–90 days) (p =.57). In multivariate analysis, ERAT (hazard ratio [HR]: 3.370; 95% confidence interval [95% CI]: 1.851–6.136; p <.001) and female sex (HR: 2.048; 95% CI: 1.114–3.768; p =.021) were the only independent predictors for LR. Conclusions: ERAT could be recorded in 21% of patients after PFA‐PVI and was an independent predictor for LR. We found no difference in the rate of LRs among patients experiencing ERAT before or after 45 days.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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