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Posterior wall isolation in persistent atrial fibrillation: pulsed-field ablation vs. radiofrequency
Session:
Sessão de Posters 31 - Fibrilhação auricular: dos mecanismos ao tratamento
Speaker:
Ana Rita Bello
Congress:
CPC 2024
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.8 Atrial Fibrillation - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Rita Bello; Gustavo Rodrigues; Daniel A. Gomes; Daniel Matos; João Carmo; Francisco Moscoso Costa; Pedro Galvão Santos; Pedro Carmo; Diogo Cavaco; Francisco Belo Morgado; Pedro Pulido Adragão
Abstract
<p style="text-align:justify"><strong>Introduction:</strong> Pulmonary vein isolation (PVI) is the mainstem of atrial fibrillation (AF) ablation. However, in persistent forms of AF the success rate is lower and additional ablation lesions have failed to improve it. Recently pulsed-field ablation (PFA) was added to the therapeutic tools for AF ablation, allowing an easier and faster posterior wall isolation (PWI). We aimed to determine the efficacy of PFA for PWI and to compare its results with radiofrequency (RF) ablation.</p> <p style="text-align:justify"><br /> <strong>Methods: </strong>Single-center retrospective study including patients with persistent AF undergoing both PVI and PWI, guided by electroanatomical mapping (CARTO). PFA was performed using Farapulse (Boston Scientific) and radiofrequency using SmartTouch or QDOT catheter (Biosense Webster). The outcome of interest was AF recurrence during follow-up (FUP).</p> <p style="text-align:justify"><br /> <strong>Results: </strong>A total of 37 patients were included (mean age 64 ± 11 years, 70% male). PWI was performed using PFA in 19 patients (51%) and radiofrequency in the remaining. There were no significant differences regarding baseline clinical characteristics. Acute PWI was demonstrated in all cases. During a median FUP of 10 [IQR 2-18] months, 8 patients (21.6%) had AF recurrence. There were no significant differences between groups regarding the arrhythmic outcome (AF recurrence in 26.3% PFA vs. 16.7% RF, P = 0.476).</p> <p style="text-align:justify"><br /> <strong>Conclusion:</strong> Acute PVI plus PWI was achieved in all patients. During FUP, most patients were in sinus rhythm. The recurrence rate was similar, regardless of the type of energy used.</p>
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