Nonthermal Point-by-Point Pulmonary Vein Isolation Using a Novel Pulsed Field Ablation System

Wenzel, Jan-Per; Lemoine, Marc D.; Rottner, Laura; My, Ilaria; Moser, Fabian; Obergassel, Julius; Nies, Moritz; Rieß, Jan; Ismaili, Djemail; Nikorowitsch, Julius; Ouyang, Feifan; Kirchhof, Paulus; Rillig, Andreas; Metzner, Andreas; Reissmann, Bruno

doi:10.1161/circep.123.012093

Cited by 5 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, a novel PFA system (CENTAURI; Galvanize Therapeutics, Phoenix, AZ, USA) was introduced, which enables monopolar biphasic PFA with commercially available, CF-sensing focal catheters in combination with their associated 3D mapping system. First single-center experiences reported convincing results during point-by-point PVI using this system [89]. However, besides PVI, effective and safe ablation of other structures, critical for atrial arrhythmias, such as the left atrial mitral isthmus (LAI) might be targeted during a left atrial ablation procedure.…”

Section: The Revolutionary Ablation Technology: Pulsed Field Ablationmentioning

confidence: 99%

Atrial Fibrillation Ablation: Current Practice and Future Perspectives

Rottner,

Metzner

2023

JCM

Self Cite

View full text Add to dashboard Cite

Catheter ablation to perform pulmonary vein isolation (PVI) is established as a mainstay in rhythm control of atrial fibrillation (AF). The aim of this review is to provide an overview of current practice and future perspectives in AF ablation. The main clinical benefit of AF ablation is the reduction of arrhythmia-related symptoms and improvement of quality of life. Catheter ablation of AF is recommended, in general, as a second-line therapy for patients with symptomatic paroxysmal or persistent AF, who have failed or are intolerant to pharmacological therapy. In selected patients with heart failure and reduced left-ventricular fraction, catheter ablation was proven to reduce all-cause mortality. Also, optimal management of comorbidities can reduce AF recurrence after AF ablation; therefore, multimodal risk assessment and therapy are mandatory. To date, the primary ablation tool in widespread use is still single-tip catheter radiofrequency (RF) based ablation. Additionally, balloon-based pulmonary vein isolation (PVI) has gained prominence, especially due to its user-friendly nature and established safety and efficacy profile. So far, the cryoballoon (CB) is the most studied single-shot device. CB-based PVI is characterized by high efficiency, convincing success rates, and a beneficial safety profile. Recently, CB-PVI as a first-line therapy for AF was shown to be superior to pharmacological treatment in terms of efficacy and was shown to reduce progression from paroxysmal to persistent AF. In this context, CB-based PVI gains more and more importance as a first-line treatment choice. Non-thermal energy sources, namely pulsed-field ablation (PFA), have garnered attention due to their cardioselectivity. Although initially applied via a basket-like ablation tool, recent developments allow for point-by-point ablation, particularly with the advent of a novel lattice tip catheter.

show abstract

Section: The Revolutionary Ablation Technology: Pulsed Field Ablationmentioning

confidence: 99%