We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Lesion formation following pulsed field ablation for pulmonary vein and posterior wall isolation.
- Authors
Sohns, Christian; Fink, Thomas; Braun, Martin; Sciacca, Vanessa; Piran, Misagh; Khalaph, Moneeb; Hamriti, Mustapha El; Guckel, Denise; Imnadze, Guram; Sommer, Philipp
- Abstract
Background: Pulsed field ablation (PFA) results in unique lesion formation, but there is lack of in–vivo validation in terms of scar formation following atrial fibrillation (AF) ablation. Objective: We aimed to access atrial lesion formation based on late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) following PFA for pulmonary vein (PV) and posterior wall isolation (PWI). Methods: AF ablation was performed in 10 patients using a 31 mm pentaspline PFA catheter. After pulmonary vein isolation (PVI; n = 8 PFA‐applications/ PV; n = 4 in basket and n = 4 in flower configuration), another eight applications in flower configuration were conducted for concomitant PWI. Patients underwent LGE CMR 3 months after ablation aiming for quantification of left atrial (LA) scar. Results: Acute procedural success was achieved in all patients. Mean procedure duration was 62 ± 7 min. and mean LA dwell time of the PFA catheter was 13 ± 2 min. Mean post ablation total LA scar burden was 8.1 ± 2.1% and mean scar width was 12.8 ± 2.1 mm. At the posterior LA, 22.6 ± 2.2% of the anatomical segment resulted in chronic scar tissue, concentrated at the PW. Postablation CMR found no evidence for PV stenosis or collateral damage of adjacent structures. At 7 months of follow‐up, 9/10 patients (90%) were free from arrhythmia recurrence. Conclusion: PFA for AF resulted in durable and transmural atrial scar tissue at the PVs and PW. LGE CMR found a very homogeneous and contiguous lesion pattern with no signs for collateral damage.
- Subjects
PATIENT aftercare; SCARS; CATHETER ablation; ATRIAL fibrillation; CONTRAST media; MAGNETIC resonance imaging; TREATMENT effectiveness; DESCRIPTIVE statistics; PULMONARY veins
- Publication
Pacing & Clinical Electrophysiology, 2023, Vol 46, Issue 7, p714
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.14727