The choice of pulsed field ablation system (PulseSelect vs FARAPULSE) had no effect on atrial fibrillation recurrence, which occurred in 39% of patients overall at a median of 12.5 months.
Cohort (n=895)
Does the choice of pulsed field ablation system (circular vs. pentaspline catheter) or the use of post-ablation high-density mapping affect atrial fibrillation recurrence in patients undergoing ablation?
There appears to be no significant difference in atrial fibrillation recurrence between circular and pentaspline pulsed field ablation systems, though increased fluoroscopy time may predict higher recurrence with the pentaspline catheter.
Atrial fibrillation (AF) is the most common arrhythmia worldwide and is associated with significant morbidity and mortality. Catheter ablation of AF has been shown to result in a significant reduction in AF burden and recurrence. Pulsed field ablation (PFA) is a new modality of catheter ablation that is noninferior to its thermal ablation counterparts, coupled with a more favorable safety profile. This study seeks to compare clinical outcomes between two PFA systems: PulseSelect™ (Medtronic, Minneapolis, MN, USA) (circular catheter) and FARAPULSE™ (Boston Scientific, Marlborough, MA, USA) (pentaspline catheter). Secondary aims are to evaluate the impacts of post-ablation mapping with a high-density mapping catheter (PAHDMC) and both procedure and fluoroscopy times on recurrence. Overall, across 895 patients with a median follow-up of 12.5 months, there was a recurrence rate of 39%. PFA system, PAHDMC, and procedure time all had no effect on recurrence. To our knowledge, this is the first study to compare recurrence rates between different PFA systems. Fluoroscopy time, however, was a significant predictor of recurrence. In the pentaspline catheter group, the odds of recurrence were 60% greater for every 15 min increase in fluoroscopy time. Future studies are needed to continue comparing outcomes amongst PFA systems and assess whether PAHDMC improves outcomes in PFAs.
Behers et al. (Tue,) conducted a cohort in Atrial fibrillation (n=895). PulseSelect (circular catheter) pulsed field ablation vs. FARAPULSE (pentaspline catheter) pulsed field ablation was evaluated on Atrial fibrillation recurrence. The choice of pulsed field ablation system (PulseSelect vs FARAPULSE) had no effect on atrial fibrillation recurrence, which occurred in 39% of patients overall at a median of 12.5 months.