Prospective 1-year results of atrial fibrillation ablation using the pentaspline pulsed field ablation catheter: The initial French experience

[Display omitted] •Initial French experience of AF ablation using the pentaspline PFA catheter.•First prospective real-world multicentre cohort.•One-year freedom from arrhythmia recurrence was 77.6%.•Rate of major complications was 2.6%.•AF at procedure start independently associated with arrhythmia...

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Published in:Archives of cardiovascular diseases 2024-04, Vol.117 (4), p.249-254
Main Authors: Chaumont, Corentin, McDonnell, Emily, Boveda, Serge, Savoure, Arnaud, Rollin, Anne, Combes, Stephane, Al Hamoud, Raphael, Mandel, Franck, Zeriouh, Sarah, Eltchaninoff, Helene, Maury, Philippe, Anselme, Frederic
Format: Article
Language:English
Subjects:
Arrhythmia
Atrial fibrillation
Atrial Fibrillation - complications
Atrial Fibrillation - diagnosis
Atrial Fibrillation - surgery
Catheter ablation
Catheter Ablation - adverse effects
Catheter Ablation - methods
Catheters
Humans
Prospective Studies
Pulmonary vein isolation
Pulmonary Veins
Pulsed field ablation
Recurrence
Treatment Outcome
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Summary:[Display omitted] •Initial French experience of AF ablation using the pentaspline PFA catheter.•First prospective real-world multicentre cohort.•One-year freedom from arrhythmia recurrence was 77.6%.•Rate of major complications was 2.6%.•AF at procedure start independently associated with arrhythmia recurrence.•Adjustment made for type of AF, LA size and rhythm at procedure start.•After adjustment, extra PV PFA applications not associated with better outcome. Pulsed field ablation has recently emerged as an interesting non-thermal energy for atrial fibrillation ablation. At a time of rapid spread of this technology, there is still a lack of prospective real-life data. To describe multicentre prospective safety and 1-year efficacy data in three of the first French centres to use pulsed field ablation. All consecutive patients undergoing a first pulsed field ablation were included prospectively. The primary outcome was freedom from documented atrial arrhythmia. The safety endpoint was a composite of major adverse events. Univariate and multivariable analyses, including patient and procedural characteristics, were performed to identify factors predictive of recurrence. Between May 2021 and June 2022, 311 patients were included (paroxysmal atrial fibrillation in 53%, persistent atrial fibrillation in 35% and long-standing persistent atrial fibrillation in 11%). Additional non-pulmonary vein pulsed field ablation applications were performed in 104/311 patients. One-year freedom from arrhythmia recurrence was 77.6% in the overall population and was significantly higher in patients with paroxysmal atrial fibrillation (88.4%) compared with patients with persistent atrial fibrillation (69.7%; P
ISSN:1875-2136
1875-2128
DOI:10.1016/j.acvd.2024.01.005