Small-basket pulsed field ablation for cavotricuspid isthmus ablation was associated with no major CCTA-detectable progression in the distal right coronary artery in 98.2% of patients.
Cohort (n=96)
Does small-basket pentaspline pulsed field ablation for cavotricuspid isthmus ablation prevent right coronary artery stenosis progression compared to radiofrequency ablation in patients undergoing atrial fibrillation ablation?
Small-basket pulsed field ablation for cavotricuspid isthmus ablation appears safe for the right coronary artery, with no major CCTA-detectable stenosis progression at 6 months.
p-value: p=0.317
BACKGROUND: Pulsed field ablation (PFA) is increasingly used for atrial fibrillation (AF) ablation; however, its safety for cavotricuspid isthmus (CTI) ablation, particularly regarding the right coronary artery (RCA), remains unclear. OBJECTIVE: To evaluate the acute and chronic effects of PFA-based CTI ablation on the RCA and to compare procedural outcomes with radiofrequency ablation (RFA). METHODS: We retrospectively analyzed 96 patients who underwent an initial CTI ablation during AF ablation and had paired pre-ablation and approximately 6-month follow-up coronary computed tomographic angiography (CCTA) data available from routine clinical care. CTI ablation was performed using a small-basket pentaspline PFA catheter (PFA group, n=55) or RFA (RFA group, n=41). We assessed RCA stenosis progression using CAD-RADS category and minimal luminal area, and also evaluated periprocedural safety and efficacy. RESULTS: In the PFA group, 54 patients (98.2%) showed no stenosis progression. The CAD-RADS category and minimal luminal area did not significantly change between pre- and follow-up CCTA (median interquartile range, 0 0-1 vs. 0 0-1, P=0.317; 11.3 8.4-15.1 vs. 11.0 8.0-15.1 mm CONCLUSIONS: Small-basket PFA for CTI ablation was associated with no major CCTA-detectable progression in the distal RCA in most patients and favorable procedural characteristics compared with RFA. Further prospective studies are needed to confirm long-term safety and efficacy.
Masuyama et al. (Mon,) conducted a cohort in Atrial fibrillation (n=96). Small-basket pentaspline pulsed field ablation (PFA) catheter vs. Radiofrequency ablation (RFA) was evaluated on Right coronary artery stenosis progression (p=0.317). Small-basket pulsed field ablation for cavotricuspid isthmus ablation was associated with no major CCTA-detectable progression in the distal right coronary artery in 98.2% of patients.
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