The LFLT catheter achieved 100% acute success for pulmonary vein isolation and 99.9% for linear lesions, with a 1.6% primary safety event rate at 7 days.
Observational (n=311)
Yes
Does the LFLT dual-energy ablation catheter safely and effectively treat recurrent atrial tachyarrhythmia in patients with prior AF ablation?
The dual-energy lattice-tip catheter demonstrates high acute procedural success and a low 7-day complication rate for redo ablation in patients with recurrent atrial tachyarrhythmias.
Abstract Background/Introduction The all-in-one mapping and dual-energy radiofrequency (RF) and pulsed field (PF) ablation catheter with a large focal (9mm) lattice-tip (LFLT) has demonstrated the ability to create durable pulmonary vein isolation (PVI) and linear lesions. Purpose To evaluate the acute performance and safety of the LFLT ablation system for treating recurrent atrial tachyarrhythmia (ATA) in patients who previously underwent atrial fibrillation (AF) ablation. Methods The APEX Registry is a prospective, multi-center, observational post-market registry involving a broad patient population treated with the LFLT catheter and proprietary mapping platform. All patients experiencing recurrent ATA after prior AF ablation were included in this analysis. Type of arrhythmia recurrence, the ablation lesion sets (including the number of applications and the energy source), as well as acute success and a predefined composite endpoint of primary safety events at 7 days were evaluated. Results At the time of analysis, 311 patients in the registry were treated for ATA following prior AF ablation (66 ± 12 years, left atrial diameter 49 ± 10mm, CHA2DS2-VASc 2.4 ± 1.6). At baseline, 76.5% of patients were on class I-IV anti-arrhythmic drugs. Nearly half of the procedures were successfully performed under deep sedation (46.0%). The majority (N=213; 68.5%) were treated for recurrent AF, 133 (42.8%) for atrial flutter, 68 (21.9%) for atrial tachycardia and 8 (2.6%) for other arrhythmias (arrhythmias not mutually exclusive). PVI-only procedure was performed in 14 (4.5%) patients, while 108 (34.7%) received PVI plus additional linear lesions (PVI+) and 189 (60.8%) received non-PVI linear lesions only. PVI-only procedures were completed in a median time of 54 47–77 min using 46 35-66 PF and 0 0-2 RF applications, PVI+ procedures took a median of 76 65–110 min and 52 31-81 PF and 9 0-19 RF applications, while non-PVI only procedures were completed in 76 58–99 min with 31 19-47 PF and 11 2-20 RF applications. A total of 122 patients (39.2%) had ≥1 pulmonary vein (PV) treated (Table 1), and 31 patients had ≥4 PVs treated. PF was the predominant energy source used for PVI, and acute success was 100% across 280 treated PVs. Most patients required linear lesions outside PVs (N=297; 95.5%). Overall, acute success (99.9%) was achieved across all 830 linear lesions, with the exception of 1 mitral isthmus line. The primary safety rate was 1.6%; 1 pulmonary edema, 2 strokes, 1 vascular access complication requiring intervention, and 1 patient developed sinus arrest that eventually required a pacemaker in the days post ablation. In addition, one transient coronary spasm was observed during cavotricuspid isthmus ablation. Conclusions In a real-world experience, the LFLT catheter proved effective for mapping and ablating recurrent ATA, targeting a wide variety of lesions with high rates of acute success and few serious complications.
Boveda et al. (Mon,) conducted a observational in Recurrent atrial tachyarrhythmia after prior AF ablation (n=311). Lattice-tip (LFLT) ablation catheter was evaluated on Acute success and primary safety events at 7 days. The LFLT catheter achieved 100% acute success for pulmonary vein isolation and 99.9% for linear lesions, with a 1.6% primary safety event rate at 7 days.