Key result
At 24-month follow-up, single procedure freedom from atrial tachyarrhythmia using the PVAC Gold catheter was 58% in patients with paroxysmal AF, 44% in persistent AF with PVI only, and 29% in persistent AF with additional substrate ablation.
Why the study?
The second-generation PVAC Gold catheter was designed to improve safety and retain efficacy for PVI, but long-term performance in daily clinical practice needed evaluation.
Observational (n=1,011)
No
Answers are grounded in this paper and cite their sources.
Phased radiofrequency ablation with the PVAC Gold catheter yields modest long-term efficacy for atrial fibrillation and high rates of pulmonary vein reconnection, suggesting it may be inferior to current mainstream ablation strategies.
PURPOSE: The second-generation multi-electrode catheter, PVAC Gold, was designed to improve the safe delivery of phased radiofrequency energy using a "single shot" approach for pulmonary vein isolation (PVI), while retaining efficacy. This large registry presents long-term performance in a daily practice setting. METHODS: A total of 1011 patients undergoing first time ablation for atrial fibrillation (AF) using PVAC Gold were included, 639 patients with PVI for paroxysmal AF (PAF PVI) and 372 patients with persistent or long-standing persistent AF, divided into 175 patients receiving PVI only (PersAF PVI) and 197 patients receiving PVI with additional substrate ablation (PersAF PVI +). RESULTS: At 24-month follow-up, single procedure freedom from atrial tachyarrhythmia (ATA) was 58% (368/639) in the PAF PVI group, 44% (77/175) in the PersAF PVI group, and 29% (57/197) in the PersAF PVI + group. Allowing one repeat procedure in 33% of patients, 76%, 65%, and 54% were free from ATA at 24 months, respectively. Pulmonary vein reconnection was observed in 98% of patients with recurrent arrhythmia after PVI. CONCLUSIONS: Although phased RF ablation with PVAC Gold is quick and safe, the efficacy outcomes are modest compared to current mainstream ablation strategies.
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Klaver et al. (2022) conducted an observational in Atrial fibrillation (n=1,011). PVAC Gold phased-RF ablation catheter was evaluated on Freedom from atrial tachyarrhythmia (ATA) at 24 months after a single procedure (p=<0.001). At 24-month follow-up, single procedure freedom from atrial tachyarrhythmia using the PVAC Gold catheter was 58% in patients with paroxysmal AF, 44% in persistent AF with PVI only, and 29% in persistent AF with additional substrate ablation.
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