Pulsed Field Ablation in Atrial Fibrillation: Initial Experience of the Efficacy and Safety in Pulmonary Vein Isolation and Beyond

Julian Cheong Kiat Tay; Jannah Lee Tarranza; Shaw Yang Chia; Xuan Ming Pung; Germaine Loo; Hooi Khee Teo; Colin Yeo; Vern Hsen Tan; Eric Tien Siang Lim; Daniel Chong; Kah Leng Ho; Chi Keong Ching

doi:10.3390/jcdd11110356

November 5, 2024Journal of Cardiovascular Development and DiseaseOpen Access

Pulsed Field Ablation in Atrial Fibrillation: Initial Experience of the Efficacy and Safety in Pulmonary Vein Isolation and Beyond

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Why the study?

Does adding posterior wall ablation (PWA) to pulmonary vein isolation (PVI) using pulsed field ablation (PFA) reduce atrial arrhythmia recurrence in patients with atrial fibrillation?

Key Points

This research evaluates the safety and efficacy of pulsed field ablation in treating atrial fibrillation and its impact on arrhythmia recurrence rates.
Initial experiences from ablation procedures with PFA for atrial fibrillation were analyzed.
Comparison of efficacy between pulmonary vein isolation (PVI) only and PVI with additional pulsed field ablation.
Assessment of 1-year arrhythmia recurrence rates and complications associated with procedures.
1-year atrial arrhythmia recurrence rates were 10% for the paroxysmal AF group and 21% for the persistent AF group.
Primary efficacy endpoint: 12-month Kaplan-Meier estimates were 90.3% for PVI-only vs. 82.8% for PVI+PWA, not significantly different.
No complications were related to the use of pulsed field ablation.

Structured PICO

Does adding posterior wall ablation (PWA) to pulmonary vein isolation (PVI) using pulsed field ablation (PFA) reduce atrial arrhythmia recurrence in patients with atrial fibrillation?

P

Population

Patients with paroxysmal atrial fibrillation (pAF) and persistent atrial fibrillation

I

Intervention

Pulsed Field Ablation (PFA) with Pulmonary Vein Isolation (PVI) plus Posterior Wall Ablation (PWA)

C

Comparator

PVI-only strategy

O

Outcome

Primary efficacy endpoint (12-month atrial arrhythmia recurrence)hard clinical

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Implication

Pulsed field ablation for AF is safe and effective, and adding posterior wall ablation to pulmonary vein isolation does not significantly improve 12-month efficacy or increase complications.

Abstract

> 0.05). The 1-year atrial arrhythmia recurrence rates were 10% for pAF and 21% for the persistent AF group. The primary efficacy endpoint was not significantly different between the PVI-only and PVI+PWA groups (12-month KM estimates 90.3% [95% CI, 83.3-97.3] and 82.8% [95% CI, 68.1-97.4], respectively). There were no complications related to PFA use. PFA can be safely, effectively, and efficiently adopted for AF ablation. Additional PWA, if pursued, had similar procedural metrics to the PVI-only strategy without increased complications.

Discussion

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Cite This Study

Tay et al. (2024) studied this question.

synapsesocial.com/papers/6a063585d13cdeb13e6ff99d https://doi.org/10.3390/jcdd11110356

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Pulsed Field Ablation in Atrial Fibrillation: Initial Experience of the Efficacy and Safety in Pulmonary Vein Isolation and Beyond

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Key Points

Structured PICO

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Implication

Abstract

Discussion

Cite This Study

Pulsed Field Ablation in Atrial Fibrillation: Initial Experience of the Efficacy and Safety in Pulmonary Vein Isolation and Beyond

Figures

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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