Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation

Abstract Introduction Pulsed field ablation (PFA) is a form of nonthermal energy that has been recently introduced for pulmonary vein isolation (PVI). A multi‐electrode pentaspline catheter for delivery of PFA guided by fluoroscopy has become widely available for clinical use. Methods and Results In...

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Main Authors: Ourania Kariki, Panagiotis Mililis, Athanasios Saplaouras, Theodoros Efremidis, Anastasios Chatziantoniou, Ioannis Panagiotopoulos, Stylianos Dragasis, Konstantinos P. Letsas, Michael Efremidis
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of Arrhythmia
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Online Access:https://doi.org/10.1002/joa3.13180
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author Ourania Kariki
Panagiotis Mililis
Athanasios Saplaouras
Theodoros Efremidis
Anastasios Chatziantoniou
Ioannis Panagiotopoulos
Stylianos Dragasis
Konstantinos P. Letsas
Michael Efremidis
author_facet Ourania Kariki
Panagiotis Mililis
Athanasios Saplaouras
Theodoros Efremidis
Anastasios Chatziantoniou
Ioannis Panagiotopoulos
Stylianos Dragasis
Konstantinos P. Letsas
Michael Efremidis
author_sort Ourania Kariki
collection DOAJ
description Abstract Introduction Pulsed field ablation (PFA) is a form of nonthermal energy that has been recently introduced for pulmonary vein isolation (PVI). A multi‐electrode pentaspline catheter for delivery of PFA guided by fluoroscopy has become widely available for clinical use. Methods and Results In this study, we aimed to assess whether the addition of electroanatomical mapping (EAM) for confirmation of PVI in the acute phase can increase the efficacy of the procedure in terms of arrhythmia recurrences. A total of 51 patients with atrial fibrillation (AF) scheduled for first time PVI were included in the study. Participants were assigned to receive PVI using fluoroscopy guidance only (Fluoro‐only group: 31 patients) or additional validation with EAM (EAM group: 20 patients). Endpoints included arrhythmia recurrence and procedural characteristics. During a 11.2 ± 1.3 months follow‐up period, arrhythmia recurrences did not statistically differ between groups (16.1% vs. 20%, p .72). Procedure time was longer in the EAM group (86.5 ± 11.4 vs. 78.4 ± 9.3 min, p .008). EAM revealed 5 nonisolated PVs that were re‐ablated using the same catheter. Four patients of the cohort underwent a redo‐procedure during the follow‐up period. In all 4 cases, at least one reconnected PV was identified. Conclusion In a cohort of patients with AF undergoing first time PVI using a pentaspline PFA catheter, PVI validation with EAM did not lead to significantly different arrhythmia recurrence rates compared to PVI without EAM. In the acute phase, the rate of nonisolated PVs was low.
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spelling doaj-art-ea73e32b954e465e923d438ffac7b5cd2024-12-11T09:53:22ZengWileyJournal of Arrhythmia1880-42761883-21482024-12-014061374137810.1002/joa3.13180Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablationOurania Kariki0Panagiotis Mililis1Athanasios Saplaouras2Theodoros Efremidis3Anastasios Chatziantoniou4Ioannis Panagiotopoulos5Stylianos Dragasis6Konstantinos P. Letsas7Michael Efremidis8Arrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceAbstract Introduction Pulsed field ablation (PFA) is a form of nonthermal energy that has been recently introduced for pulmonary vein isolation (PVI). A multi‐electrode pentaspline catheter for delivery of PFA guided by fluoroscopy has become widely available for clinical use. Methods and Results In this study, we aimed to assess whether the addition of electroanatomical mapping (EAM) for confirmation of PVI in the acute phase can increase the efficacy of the procedure in terms of arrhythmia recurrences. A total of 51 patients with atrial fibrillation (AF) scheduled for first time PVI were included in the study. Participants were assigned to receive PVI using fluoroscopy guidance only (Fluoro‐only group: 31 patients) or additional validation with EAM (EAM group: 20 patients). Endpoints included arrhythmia recurrence and procedural characteristics. During a 11.2 ± 1.3 months follow‐up period, arrhythmia recurrences did not statistically differ between groups (16.1% vs. 20%, p .72). Procedure time was longer in the EAM group (86.5 ± 11.4 vs. 78.4 ± 9.3 min, p .008). EAM revealed 5 nonisolated PVs that were re‐ablated using the same catheter. Four patients of the cohort underwent a redo‐procedure during the follow‐up period. In all 4 cases, at least one reconnected PV was identified. Conclusion In a cohort of patients with AF undergoing first time PVI using a pentaspline PFA catheter, PVI validation with EAM did not lead to significantly different arrhythmia recurrence rates compared to PVI without EAM. In the acute phase, the rate of nonisolated PVs was low.https://doi.org/10.1002/joa3.13180atrial fibrillationcatheter ablationelectroanatomical mappingpulmonary vein isolationpulsed field ablation
spellingShingle Ourania Kariki
Panagiotis Mililis
Athanasios Saplaouras
Theodoros Efremidis
Anastasios Chatziantoniou
Ioannis Panagiotopoulos
Stylianos Dragasis
Konstantinos P. Letsas
Michael Efremidis
Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
Journal of Arrhythmia
atrial fibrillation
catheter ablation
electroanatomical mapping
pulmonary vein isolation
pulsed field ablation
title Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
title_full Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
title_fullStr Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
title_full_unstemmed Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
title_short Investigating the role of electroanatomical mapping in single‐shot pulsed field catheter ablation
title_sort investigating the role of electroanatomical mapping in single shot pulsed field catheter ablation
topic atrial fibrillation
catheter ablation
electroanatomical mapping
pulmonary vein isolation
pulsed field ablation
url https://doi.org/10.1002/joa3.13180
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