Arrhythmias & electrophysiologyCohort study
Coronary Artery Spasm During Pulsed Field vs Radiofrequency Catheter Ablation of the Mitral Isthmus
- Prospective cohort study
- single-centre
- consecutive patients
Authors' conclusion
When creating a mitral isthmus ablation line during catheter ablation of atrial fibrillation, adjacent left circumflex arterial vasospasm frequently occurred with PFA and not RFA but was typically subclinical.
Study context
- Population
- Adults receiving first-ever pulsed field ablation (PFA) or radiofrequency ablation (RFA) of the mitral isthmus during catheter ablation of AF, single European referral centre, 2022
- Participants
- 26 adults
- Exposure
- PFA vs RFA of the mitral isthmus
- PFAn = 17
- RFAn = 9reference
- Outcome
- Frequency and severity of left circumflex arterial vasospasm, time to remission and need for nitroglycerin
- Follow-up
- Acute
Main finding
As reported in the abstract
Coronary spasm
PFA
41.2%
7 of 17
RFA
0
events
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Coronary spasm with PFA, by position of the mitral isthmus ablation line (subgroup) | PFA, line situated superiorly 77.8% · PFA, line situated inferiorly 0 events |
| Coronary spasm with crossover PFA after failed RFA | Crossover PFA 60% |
- Coronary spasm with PFA, by position of the mitral isthmus ablation line (subgroup): superior: 7 of 9; inferior: 0 of 8
- Coronary spasm with crossover PFA after failed RFA: 5 patients
Severity of spasm
- Subclinical spasm (9 of 10)
- 90%
- Nitroglycerin required (2 of 10)
- 20%
Time to resolution of spasm
- Median (range) time to resolution, minutes
- 5 (5-25)
Original publication
Coronary Artery Spasm During Pulsed Field vs Radiofrequency Catheter Ablation of the Mitral Isthmus. JAMA Cardiol. Published 1 January 2024. doi:10.1001/jamacardio.2023.4405
Summarised from the published abstract; every number is checked against it