Pulsed field ablation for pulmonary vein isolation: real-world experience and characterization of the antral lesion size compared with cryoballoon ablation

Blockhaus, Christian; Guelker, Jan‐Erik; Feyen, Ludger; Seyfarth, Melchior; Shin, Dong‐In

doi:10.1007/s10840-022-01359-x

Cited by 10 publications

(19 citation statements)

References 22 publications

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“…The success rate of PVI was not 100% in four 12,21,22,24 out of the 10 reported studies 7,12,13,19–25 . The only study among those reporting PVI in which the PFA group failed to achieve successful isolation of PVs was conducted by Reddy et al 21 .…”

Section: Resultsmentioning

confidence: 99%

“…The PRISMA flow chart provides a systematic description of the literature selection process (Figure 1). Ultimately, this study encompassed 15 trials involving a total of 1880 patients (1036 patients in the PFA group vs. 844 patients in the CBA group) published between 2021 and 2023, 7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25] comprising of 14 observational studies (7 prospective cohort, 7,12,16,17,19,23,25 6 retrospective cohort, 13,14,18,20,22,24 and 1 cross-sectional study 15 ), along with one RCT. 21 Five studies included patients with paroxysmal AF, 7,[17][18][19]21 while the remaining studies enrolled a broader population of AF patients.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…The success rate of PVI was not 100% in four 12,21,22,24 out of the 10 reported studies. 7,12,13,[19][20][21][22][23][24][25] The only study among those reporting PVI in which the PFA group failed to achieve successful isolation of PVs was conducted by Reddy et al 21 However, the two techniques did not show any significant difference in achieving acute isolation of all PVs (OR 2.36; 95% CI, 0.82−6.81; p = .11; I 2 = 0%; Supplement Figure 1).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Of the 13 cohort studies, 3 (23%) were rated as having moderate quality, 13,16,17 while the remaining studies demonstrated high quality;…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

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Meta‐analysis of pulsed‐field ablation versus cryoablation for atrial fibrillation

Zhang,

et al. 2024

Pacing Clinical Electrophis

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PurposeThe available data on the treatment strategy of pulsed field ablation (PFA) for patients with atrial fibrillation (AF) is limited. This study aims to provide a comparative analysis of the efficacy, safety, and procedural efficiency between PFA and cryoballoon ablation (CBA) for AF.MethodsWe conducted a comprehensive search of the EMBASE, PubMed, Cochrane Library, and ClinicalTrials.gov databases to identify trials comparing PFA with CBA for AF from their inception until December 2023. The odds ratio (OR) and mean difference (MD), along with a 95% confidence interval (CI), were utilized as measures of treatment effect.ResultsThe analysis included 15 eligible trials with a total enrollment of 1880 patients. No significant differences were found in recurrent atrial arrhythmia (OR 0.83, 95% CI 0.64, 1.07) or periprocedural complications (OR 0.78, 95% CI 0.46, 1.30) between the two ablation techniques examined in this study. However, the PFA technique demonstrated a significantly shorter procedure time (MD ‐7.17, 95% CI ‐13.60, ‐0.73), but a longer fluoroscopy time (MD 2.53, 95% CI 0.87, 4.19). Similarly, PFA was found to be significantly associated with a decreased incidence of phrenic nerve palsy (OR 0.20, 95% CI 0.07, 0.59), but an increased incidence of cardiac tamponade (OR 4.07, 95% CI 1.15, 14.39). Moreover, there was a significantly higher release of troponin with PFA compared to CBA (MD 470.28, 95% CI 18.89, 921.67), while the increase in S100 protein and heart rate was significantly lower with PFA than with CBA (MD ‐64.41, 95% CI ‐105.46, ‐17.36), (MD ‐8.76, 95% CI ‐15.12, ‐2.40).ConclusionThe utilization of PFA provides a safer, time‐saving, and tissue‐specific procedure compared to CBA, while maintaining comparable success rates. This has the potential to enhance procedural efficiency and optimize resource utilization in clinical practice. These findings underscore the feasibility and promise of PFA as an alternative technique for PVI in patients with AF.

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Section: Resultsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Of the 13 cohort studies, 3 (23%) were rated as having moderate quality, 13,16,17 while the remaining studies demonstrated high quality;…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

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Meta‐analysis of pulsed‐field ablation versus cryoablation for atrial fibrillation

Zhang,

et al. 2024

Pacing Clinical Electrophis

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“…[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] More recently, novel energy sources and mapping algorithms have also been explored for AF catheter ablation. [27][28][29][30][31][32][33] Even with more sophisticated approaches, superior longterm effective treatment for AF above what is achievable with PVI alone has been a challenge. [34][35][36][37][38] However, could a key missing link lie outside the heart itself and be nestled within the nervous system?…”

mentioning

confidence: 99%

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

Aksu

Skeete

Huang

2023

Arrhythm Electrophysiol Rev

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As the most common sustained arrhythmia, AF is a complex clinical entity which remains a difficult condition to durably treat in the majority of patients. Over the past few decades, the management of AF has focused mainly on pulmonary vein triggers for its initiation and perpetuation. It is well known that the autonomic nervous system (ANS) has a significant role in the milieu predisposing to the triggers, perpetuators and substrate for AF. Neuromodulation of ANS – ganglionated plexus ablation, vein of Marshall ethanol infusion, transcutaneous tragal stimulation, renal nerve denervation, stellate ganglion block and baroreceptor stimulation – constitute an emerging therapeutic approach for AF. The purpose of this review is to summarise and critically appraise the currently available evidence for neuromodulation modalities in AF.

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The right modality for the right pulmonary vein shape in ablation for atrial fibrillation

Isaksen

Manninger

Linz

2022

J Interv Card Electrophysiol

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Pulsed field ablation for pulmonary vein isolation: real-world experience and characterization of the antral lesion size compared with cryoballoon ablation

Cited by 10 publications

References 22 publications

Meta‐analysis of pulsed‐field ablation versus cryoablation for atrial fibrillation

Meta‐analysis of pulsed‐field ablation versus cryoablation for atrial fibrillation

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

The right modality for the right pulmonary vein shape in ablation for atrial fibrillation

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