Arrhythmias & electrophysiology
Feasibility of reversible electroporation mapping in human atrial flutter
Authors' conclusion
PFREV mapping of reentrant atrial tachycardia is feasible, with termination and TCL prolongation reproducibly identifying the critical isthmus with 100% specificity. Sensitivity of PFREV mapping is influenced by the isthmus electroanatomic characteristics.
Study context
- Population
- Patients with atrial flutter receiving reversible pulsed field ablation (PFREV) pulses delivered with a 9-mm lattice-tip ablation catheterpatients, 100 nonpropagated PFREV pulses in 24 tachycardias
- Participants
- 21 patients
- Comparison
- PFREV pulses at sites in and outside the circuit
- Isthmusn = 54
- Outer loop sitesn = 20
- Outside the circuitn = 26
- Outcome
- Distribution of nonpropagated PFREV pulses
Main finding
As reported in the abstract
Further findings
Isthmus width, no PFREV effect vs termination or prolongation
P < 0.001
- Isthmus width, no PFREV effect vs termination or prolongation: isthmus significantly wider when no PFREV effect was observed
Response to PFREV pulses delivered at the isthmus
- Termination, of the pulses delivered at the isthmus
- 9 (16.7%)
- Tachycardia cycle length (TCL) prolongation, of the pulses delivered at the isthmus
- 10 (18.5%)
- No effect, of the pulses delivered at the isthmus
- 35 (64.8%)
Response to PFREV pulses at outer loop and outside the circuit
- None of the PFREV pulses delivered at the outer loop and outside the circuit induced any change
Reproducibility of response at the same site
- Same type of response
- 85%
- Same response when termination and prolongation were combined
- 90%
Original publication
Feasibility of reversible electroporation mapping in human atrial flutter. Heart Rhythm. Published 17 April 2025. doi:10.
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