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Incidence of atrial fibrillation during the first week of blanking period: Pulsed-field ablation vs High-power short-duration radiofrequency ablation
Session:
Best Posters
Speaker:
Patricia Matias
Congress:
CPC 2024
Topic:
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Session Type:
Cartazes
FP Number:
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Authors:
Patricia Matias; Daniel Gomes; Daniel Matos; João Carmo; Gustavo Rodrigues; Pedro G Santos; Francisco Costa; Pedro Carmo; Francisco Morgado; Diogo Cavaco; Pedro Adragão
Abstract
<p><u><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction:</span></span></u></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Pulsed-field (PFA) is a new source of energy for atrial fibrillation (AF) ablation. It uses ultrashort high-energy electrical pulses inducing a non-thermal necrosis (without inflammatory response). On the other hand, high-power short-duration radiofrequency (HPSD RF) ablation causes thermal (coagulation) necrosis and consequent inflammatory response. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We aimed to compare the incidence of AF during the first week after ablation using these 2 different types of energy (PFA vs HPSD RF).</span></span></p> <p><u><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods:</span></span></u></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Single-center registry of patients undergoing AF ablation. Patients were classified according to the type of ablation energy employed (PFA with Farapulse [Boston Scientific] or HPSD RF [QDOT, Biosense Webster]). After the procedure, all patients underwent electrocardiographic monitoring with a 7-day Holter monitor. The outcome of interest was AF recurrence during the first week after ablation.</span></span></p> <p><u><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results:</span></span></u></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A total of 53 patients underwent AF ablation using PFA (n=19) or HPSD RF (n=34). The mean age was 63±12 years, 61% were male and 75% had paroxysmal AF. There were no significant differences regarding baseline clinical characteristics between groups. Particularly, 68% of patients (n=13) in the PFA group and 79% submitted to HPSD RF (n=27) had a paroxysmal form of AF (p=0.372). During the first week of follow-up after AF ablation, 20.6% of patients had a numerically higher recurrence rate in the HPSD RF subgroup vs. 5.3% in the PFA (p=0.135). There was no relationship between the type of AF and the outcome of interest (1 patient in the PFA and 6 patients in the HPSD RF group had paroxysmal AF). </span></span></p> <p><u><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion:</span></span></u></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Patients who underwent PFA <span style="color:#212121">for the treatment of AF</span> had four times less AF recurrence in the first week following the procedure when compared to HPSD RF, although not achieving statistical significance. We can hypothesize that the fewer arrhythmic events during the initial period after ablation in the PFA group may be associated with less inflammatory response. While the long-term implications of these findings must be enlightened, larger studies are needed to confirm these results.</span></span></p>
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