Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres
Introduction Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.Methods Data collected...
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BMJ Publishing Group
2024-12-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/11/2/e003094.full |
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| author | Tom Wong Mark T Mills Shajil Chalil Francis Murgatroyd Scott Gall Aruna Arujuna David Jones Mark O'Neill Claire Martin Zhong Chen Shui Hao Chin Dhiraj Gupta Derick M Todd Sarah Zeriouh Greg Mellor Vishal Luther Richard Balasubramaniam Mark Sopher Matthew J Lovell Riyaz Somani Peter Calvert Riyaz A Kaba Saket Trivedi Julian Boullin Magdi Saba Una Buckley |
| author_facet | Tom Wong Mark T Mills Shajil Chalil Francis Murgatroyd Scott Gall Aruna Arujuna David Jones Mark O'Neill Claire Martin Zhong Chen Shui Hao Chin Dhiraj Gupta Derick M Todd Sarah Zeriouh Greg Mellor Vishal Luther Richard Balasubramaniam Mark Sopher Matthew J Lovell Riyaz Somani Peter Calvert Riyaz A Kaba Saket Trivedi Julian Boullin Magdi Saba Una Buckley |
| author_sort | Tom Wong |
| collection | DOAJ |
| description | Introduction Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.Methods Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.Results 1034 procedures were submitted. The patients were 32.1% female, mean age 63.8±10.7 years, 53.1% paroxysmal AF and 89.7% first-time AF ablation. Procedures were performed by 48 consultant operators at nine NHSE centres, with a mean of 115 procedures per centre (range 25–264). 93.7% of procedures were performed under general anaesthesia. Median skin-to-skin procedure time was 74 min (IQR 55–96 min) and fluoroscopy time 20 min (IQR 15–27 min). Electroanatomical mapping was used in 15.3%. In first-time ablation cases, acute isolation of all pulmonary veins was achieved in 99.5% of patients. Left atrial (LA) posterior wall ablation using the PFA catheter was performed in 11.0% of cases; additional LA radiofrequency ablation was performed in 0.6%. The major and minor acute procedural complication rates were, respectively, 1.3% and 3.1%, with no reports of periprocedural death or atrio-oesophageal fistula. 63.8% of patients were discharged on the day of procedure. Follow-up data were available for 870 procedures (84.1%). In the 3 months following ablation, hospitalisation for arrhythmia occurred in 3.2%, with 0.9% rehospitalised for procedural-related complications.Conclusion In this real-world, nationwide registry of a pentaspline PFA catheter, efficacy, safety and efficiency outcomes were comparable to those from previous PFA studies in patients with AF. |
| format | Article |
| id | doaj-art-abc854c4de224c5fb2c12f0a047e8c7b |
| institution | Kabale University |
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| publishDate | 2024-12-01 |
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| series | Open Heart |
| spelling | doaj-art-abc854c4de224c5fb2c12f0a047e8c7b2024-12-23T18:15:09ZengBMJ Publishing GroupOpen Heart2053-36242024-12-0111210.1136/openhrt-2024-003094Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centresTom Wong0Mark T Mills1Shajil Chalil2Francis Murgatroyd3Scott Gall4Aruna Arujuna5David Jones6Mark O'Neill7Claire Martin8Zhong Chen9Shui Hao Chin10Dhiraj Gupta11Derick M Todd12Sarah Zeriouh13Greg Mellor14Vishal Luther15Richard Balasubramaniam16Mark Sopher17Matthew J Lovell18Riyaz Somani19Peter Calvert20Riyaz A Kaba21Saket Trivedi22Julian Boullin23Magdi Saba24Una Buckley25Royal Brompton and Harefield Hospitals, London, UKLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UKLancashire Cardiac Centre, Victoria Hospital, Blackpool Teaching Hospitals NHS Trust Foundation, Blackpool, UKNHS England Cardiac Rhythm Management Device Working Group, London, UKLancashire Cardiac Centre, Victoria Hospital, Blackpool Teaching Hospitals NHS Trust Foundation, Blackpool, UKLancashire Cardiac Centre, Victoria Hospital, Blackpool Teaching Hospitals NHS Trust Foundation, Blackpool, UKRoyal Brompton and Harefield Hospitals, London, UKGuy`s and St Thomas` NHS Foundation Trust, London, UKRoyal Papworth Hospital NHS Foundation Trust, Cambridge, UKRoyal Brompton and Harefield Hospitals, London, UKUniversity Hospitals of Leicester NHS Trust, Leicester, UKLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UKLiverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UKRoyal Papworth Hospital NHS Foundation Trust, Cambridge, UKRoyal Papworth Hospital NHS Foundation Trust, Cambridge, UKLiverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, UKUniversity Hospitals Dorset NHS Foundation Trust, Bournemouth, UKUniversity Hospitals Dorset NHS Foundation Trust, Bournemouth, UKNHS England Cardiac Rhythm Management Device Working Group, London, UKUniversity Hospitals of Leicester NHS Trust, Leicester, UKLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UKSt George`s University Hospitals NHS Foundation Trust, London, UKNHS England Cardiac Rhythm Management Device Working Group, London, UKUniversity Hospitals Dorset NHS Foundation Trust, Bournemouth, UKSt George`s University Hospitals NHS Foundation Trust, London, UKGuy`s and St Thomas` NHS Foundation Trust, London, UKIntroduction Pulsed-field ablation (PFA) is a novel modality for pulmonary vein isolation in patients with atrial fibrillation (AF). We describe the initial uptake and experience of PFA using a pentaspline catheter across selected National Health Service England (NHSE) centres.Methods Data collected by NHSE Specialised Services Development Programme regarding AF ablation procedures using a single-shot, pentaspline, multielectrode PFA catheter (FARAWAVE, Boston Scientific) between June 2022 and August 2024 were aggregated and analysed to examine procedural metrics, acute efficacy and safety outcomes over 3-month follow-up.Results 1034 procedures were submitted. The patients were 32.1% female, mean age 63.8±10.7 years, 53.1% paroxysmal AF and 89.7% first-time AF ablation. Procedures were performed by 48 consultant operators at nine NHSE centres, with a mean of 115 procedures per centre (range 25–264). 93.7% of procedures were performed under general anaesthesia. Median skin-to-skin procedure time was 74 min (IQR 55–96 min) and fluoroscopy time 20 min (IQR 15–27 min). Electroanatomical mapping was used in 15.3%. In first-time ablation cases, acute isolation of all pulmonary veins was achieved in 99.5% of patients. Left atrial (LA) posterior wall ablation using the PFA catheter was performed in 11.0% of cases; additional LA radiofrequency ablation was performed in 0.6%. The major and minor acute procedural complication rates were, respectively, 1.3% and 3.1%, with no reports of periprocedural death or atrio-oesophageal fistula. 63.8% of patients were discharged on the day of procedure. Follow-up data were available for 870 procedures (84.1%). In the 3 months following ablation, hospitalisation for arrhythmia occurred in 3.2%, with 0.9% rehospitalised for procedural-related complications.Conclusion In this real-world, nationwide registry of a pentaspline PFA catheter, efficacy, safety and efficiency outcomes were comparable to those from previous PFA studies in patients with AF.https://openheart.bmj.com/content/11/2/e003094.full |
| spellingShingle | Tom Wong Mark T Mills Shajil Chalil Francis Murgatroyd Scott Gall Aruna Arujuna David Jones Mark O'Neill Claire Martin Zhong Chen Shui Hao Chin Dhiraj Gupta Derick M Todd Sarah Zeriouh Greg Mellor Vishal Luther Richard Balasubramaniam Mark Sopher Matthew J Lovell Riyaz Somani Peter Calvert Riyaz A Kaba Saket Trivedi Julian Boullin Magdi Saba Una Buckley Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres Open Heart |
| title | Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres |
| title_full | Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres |
| title_fullStr | Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres |
| title_full_unstemmed | Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres |
| title_short | Pulsed-field ablation of atrial fibrillation with a pentaspline catheter across National Health Service England centres |
| title_sort | pulsed field ablation of atrial fibrillation with a pentaspline catheter across national health service england centres |
| url | https://openheart.bmj.com/content/11/2/e003094.full |
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