Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study
Background Cryoballoon ablation is currently the gold standard technique for single‐shot pulmonary vein isolation (PVI). Pulsed field ablation (PFA) has recently emerged as an interesting nonthermal alternative energy for PVI. The purpose of our study was to evaluate the safety and long‐term efficac...
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033146 |
| _version_ | 1797257407786647552 |
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| author | Corentin Chaumont Camilia Hayoun Arnaud Savoure Raphael Al Hamoud Nathanael Auquier Emily McDonnell Helene Eltchaninoff Frederic Anselme |
| author_facet | Corentin Chaumont Camilia Hayoun Arnaud Savoure Raphael Al Hamoud Nathanael Auquier Emily McDonnell Helene Eltchaninoff Frederic Anselme |
| author_sort | Corentin Chaumont |
| collection | DOAJ |
| description | Background Cryoballoon ablation is currently the gold standard technique for single‐shot pulmonary vein isolation (PVI). Pulsed field ablation (PFA) has recently emerged as an interesting nonthermal alternative energy for PVI. The purpose of our study was to evaluate the safety and long‐term efficacy of PVI using the pentaspline PFA catheter in comparison to cryoballoon ablation. Methods and Results Between January 2021 and December 2022, we included all consecutive patients of our center in whom a first PVI‐only procedure was performed using PFA or cryoballoon. The choice of the energy was based on patients' preference between general anesthesia (PFA) and local anesthesia (cryoballoon). The primary end point was freedom from documented atrial arrhythmia recurrence after a 3‐month blanking period. A total of 301 patients (paroxysmal atrial fibrillation in 220 patients) underwent a first PVI procedure performed using PFA (n=151) or cryoballoon (n=150). Complete short‐term PVI was obtained in 144 of 150 patients (96%) in the cryoballoon group and in all patients of the PFA group (P=0.01). Procedure duration was significantly longer in the cryoballoon group. Transient and persistent phrenic nerve injuries were observed in the cryoballoon group only (13/150 and 2/150, respectively). One‐year freedom from atrial arrhythmia was significantly higher in the PFA group compared with the cryoballoon group (87.9% versus 77.7%; adjusted hazard ratio, 0.53 [95% CI, 0.30–0.96]; P=0.037). Conclusions This prospective, comparative, real‐life study suggested that PFA could overcome safety limitations of cryoballoon with optimal effectiveness. Randomized controlled studies are required to further investigate the potential superiority of PFA over cryoballoon. |
| first_indexed | 2024-04-24T22:37:09Z |
| format | Article |
| id | doaj.art-b3e1589af5fc4fa9b320fc971c3894c1 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T22:37:09Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b3e1589af5fc4fa9b320fc971c3894c12024-03-19T10:07:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-03-0113610.1161/JAHA.123.033146Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative StudyCorentin Chaumont0Camilia Hayoun1Arnaud Savoure2Raphael Al Hamoud3Nathanael Auquier4Emily McDonnell5Helene Eltchaninoff6Frederic Anselme7Department of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceDepartment of Cardiology Rouen University Hospital Rouen FranceBackground Cryoballoon ablation is currently the gold standard technique for single‐shot pulmonary vein isolation (PVI). Pulsed field ablation (PFA) has recently emerged as an interesting nonthermal alternative energy for PVI. The purpose of our study was to evaluate the safety and long‐term efficacy of PVI using the pentaspline PFA catheter in comparison to cryoballoon ablation. Methods and Results Between January 2021 and December 2022, we included all consecutive patients of our center in whom a first PVI‐only procedure was performed using PFA or cryoballoon. The choice of the energy was based on patients' preference between general anesthesia (PFA) and local anesthesia (cryoballoon). The primary end point was freedom from documented atrial arrhythmia recurrence after a 3‐month blanking period. A total of 301 patients (paroxysmal atrial fibrillation in 220 patients) underwent a first PVI procedure performed using PFA (n=151) or cryoballoon (n=150). Complete short‐term PVI was obtained in 144 of 150 patients (96%) in the cryoballoon group and in all patients of the PFA group (P=0.01). Procedure duration was significantly longer in the cryoballoon group. Transient and persistent phrenic nerve injuries were observed in the cryoballoon group only (13/150 and 2/150, respectively). One‐year freedom from atrial arrhythmia was significantly higher in the PFA group compared with the cryoballoon group (87.9% versus 77.7%; adjusted hazard ratio, 0.53 [95% CI, 0.30–0.96]; P=0.037). Conclusions This prospective, comparative, real‐life study suggested that PFA could overcome safety limitations of cryoballoon with optimal effectiveness. Randomized controlled studies are required to further investigate the potential superiority of PFA over cryoballoon.https://www.ahajournals.org/doi/10.1161/JAHA.123.033146atrial fibrillationcatheter ablationcryoballoon ablationpulmonary vein isolationpulsed field ablation |
| spellingShingle | Corentin Chaumont Camilia Hayoun Arnaud Savoure Raphael Al Hamoud Nathanael Auquier Emily McDonnell Helene Eltchaninoff Frederic Anselme Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation catheter ablation cryoballoon ablation pulmonary vein isolation pulsed field ablation |
| title | Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study |
| title_full | Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study |
| title_fullStr | Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study |
| title_full_unstemmed | Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study |
| title_short | Pentaspline Pulsed Field Ablation Catheter Versus Cryoballoon for Atrial Fibrillation Ablation: Results From a Prospective Comparative Study |
| title_sort | pentaspline pulsed field ablation catheter versus cryoballoon for atrial fibrillation ablation results from a prospective comparative study |
| topic | atrial fibrillation catheter ablation cryoballoon ablation pulmonary vein isolation pulsed field ablation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033146 |
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