National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety

Bisignani, Antonio; Schiavone, Marco; Solimene, Francesco; Dello Russo, Antonio; Filannino, Pasquale; Magnocavallo, Michele; Tondo, Claudio; Schillaci, Vincenzo; Casella, Michela; Petretta, Andrea; Rossi, Pietro; Fassini, Gaetano; Rossillo, Antonio; Maggio, Ruggero; Themistoclakis, Sakis; Pandozi, Claudio; Polselli, Marco; Tundo, Fabrizio; Arestia, Alberto; Compagnucci, Paolo; Valente Perrone, Annelisa; Malacrida, Maurizio; Iacopino, Saverio; Bianchi, Stefano

doi:10.1007/s10840-024-01835-6

J Interv Card Electrophysiol

2024

DOI: 10.1007/s10840-024-01835-6

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National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety

Antonio Bisignani,

Marco Schiavone,

Francesco Solimene

et al.

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2024

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Anatomical-guided third-generation laser balloon ablation for the treatment of paroxysmal atrial fibrillation assessed by continuous rhythm monitoring: results from a multicentre prospective study

Ciconte,

Schiavone,

Rovaris

et al. 2024

Europace

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Aims The third-generation laser balloon (LB3) is an established ablation device for pulmonary vein isolation (PVI) that allows direct visualization of the anatomical target. Equipped with an automatic circumferential laser delivery modality, it aims at continuous circumferential PVI, improving both acute and clinical outcomes. We sought to evaluate the clinical efficacy of LB3 ablation using an anatomical-based approach without verifying electrical isolation. Methods and results Among 257 paroxysmal AF patients undergoing LB3 ablation across four Italian centres, 204 (72% male, mean age 60.4 ± 11.1 years) were included. The primary endpoint was freedom from any atrial tachyarrhythmia (ATa) recurrence after the blanking period (BP), assessed with implantable cardiac monitors (ICMs). All pulmonary veins (PVs) were targeted using the LB3, with the RAPID mode used on an average of 96 ± 8, 86 ± 19, 98 ± 11, and 84 ± 15% for the left superior, left inferior, right superior, right inferior PV, and left common ostium, respectively. Freedom from arrhythmia recurrences was 84.8% at 1, 80.4% at 2, and 76.0% at 3 years. An ATa burden ≥ 5% was documented in 2.5, 4.4, and 5.4% at 1, 2, and 3 years, respectively. Relapses during the BP [hazard ratio (HR) = 2.182, P = 0.032] and left atrial dilation (HR = 1.964, P = 0.048) were independent predictors of recurrences. Conclusion Anatomical-guided LB3 ablation for paroxysmal AF is a safe and effective approach, providing excellent clinical outcomes as assessed by ICM over nearly 3 years of follow-up.

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Anatomical-guided third-generation laser balloon ablation for the treatment of paroxysmal atrial fibrillation assessed by continuous rhythm monitoring: results from a multicentre prospective study

Ciconte,

Schiavone,

Rovaris

et al. 2024

Europace

View full text Add to dashboard Cite

show abstract

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National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety

Cited by 1 publication

References 27 publications

Anatomical-guided third-generation laser balloon ablation for the treatment of paroxysmal atrial fibrillation assessed by continuous rhythm monitoring: results from a multicentre prospective study

Anatomical-guided third-generation laser balloon ablation for the treatment of paroxysmal atrial fibrillation assessed by continuous rhythm monitoring: results from a multicentre prospective study

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