Arrhythmias & electrophysiologySecondary analysis
Characteristics of Recurrent Atrial Arrhythmias and Lesion Assessment Late After Pulsed Field Ablation of Atrial Fibrillation
- substudy of the FRANCE pulsed field ablation (PFA) national exhaustive multicentric registry
Authors' conclusion
In patients undergoing redo procedures after an initial AF ablation using the pentaspline PFA catheter, AF was less frequently observed when ablation lesions were performed beyond PVs. A high rate of durable PVI or block was achieved with >12 PFA applications per PV and >16 for the roof/PW. Long-term durability of mitral isthmus block was poor using the Pentaspline PFA catheter.
Study context
- Population
- Patients with arrhythmia recurrence after initial AF ablation with pulsed field ablation undergoing redo procedures with 3-dimensional mappingpatients with arrhythmia recurrence undergoing redo procedures with 3-dimensional mapping
- Participants
- 145 patients
Primary result
As reported in the abstract
AF
58%
atrial tachycardia
28%
typical atrial flutter
8%
Further findings
AF recurrence when initial ablation targeted extra-PV areas
- AF with vs without extra-PV ablation
- 45 versus 71%
- P =0.01
AF recurrence when a 35-mm diameter catheter was used for PV isolation (PVI) only
- AF
- 50 versus 77%
- P =0.01
Durable PVI and line block at redo
- Complete durable PVI
- 42%
- Durable PVI for each separate pulmonary vein (PV)
- 69% to 76%
- Durable roof/PW block
- 62%
- Durable mitral isthmus block
- 31%
Durable PVI by number of PFA applications
- Durable PVI with >12 applications
- 84%
- increased with the number of PFA applications ( P <0.05)
Roof/PW block by number of applications
- Roof/PW block with >16 applications
- 88%
- P <0.01
Mitral isthmus block by number of applications
- Mitral isthmus block rate
- 31%
- not significantly associated with application number
Original publication
Summarised from the published abstract; every number is checked against it