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Pulmonary vein isolation (PVI) is the most effective treatment for rhythm control. Additional advantages include providing electrophysiology lab personnel with a lead-free working environment and avoiding radiation exposure for both patients and physicians. It has initially been performed with fluoroscopic catheter guiding.
Based on continuous monitoring of early recurrence of atrial tachyarrhythmia immediately after patients have undergone atrial fibrillation ablation, Musat et al. Early recurrence of atrial tachyarrhythmia (ERAT) is commonly seen following catheter ablation of AF, with reported incidences of up to 61% in the first three months.
Distribution Variance of Focal Atrial Tachycardia Foci and Long-Term Outcomes After Ablation. We aimed to evaluate age differences in foci and factors influencing recurrence after radiofrequency catheter ablation in adult and juvenile patients with FAT. After a mean follow-up of 47.2 months, FAT recurred in 57 patients.
Food and Drug Administration (FDA), has granted approval to Boston Scientific for its FARAPULSE Pulsed Field Ablation System. A company statement reported that its PFA System is indicated for the isolation of pulmonary veins in the treatment of drug-refractory, recurrent, symptomatic, paroxysmal (i.e.,
During its Annual Conference, HRS 2024, the Heart Rhythm Society (HRS) announced findings from three new studies demonstrating the safety and efficacy of pulsed field ablation (PFA), a nonthermal ablation treatment for patients with atrial fibrillation (AF). See full findings from the FARADISE, admIRE Study, and Advent Trial here.
The international, multi-center trial will provide clinical evaluation of Cortex's 510(k) cleared Ablamap System with electrographic flow (EGF) and newly released Ablacath Mapping Catheter basket mapping catheter to identify extra-pulmonary vein EGF sources. and may enroll up to 400 subjects across 20+ centers in the US and Europe.
Despite the relative efficacy of ablation, the risk of AF recurrence is substantial, particularly in patients with persistent AF (perAF). At present we do not have any reliable intra-procedural electrophysiologic predictors of long-term success of AF ablation other than pulmonary vein isolation.
Outcomes of ablation with the FARAPULSE PFA System – a nonthermal treatment in which electric fields selectively ablate heart tissue – will be compared to outcomes following use of anti-arrhythmic drug (AAD) therapy, which is commonly prescribed for patients living with persistent AF. The company now anticipates U.S. Circulation.
Launching the first FDA -approved PFA technology is not just a milestone; the PulseSelect PFA system is setting a new standard in safety for AF ablation with excellent efficacy and efficiency 1. In my clinical experience with the catheter, it was designed for AF ablation procedures.
The AFib pulsed field ablation treatment era officially began in the US last week, following the FDA approval of Medtronic’s PulseSelect Pulsed Field Ablation System for the treatment of both paroxysmal and persistent atrial fibrillation. PFA systems use electroporation (short electrical pulses) to achieve pulmonary vein isolation.
Abstract Introduction Some previous studies have reported that a first-step ethanol infusion into the vein of Marshall (EIVOM) with touch-up radiofrequency (RF) ablation can facilitate mitral isthmus (MI) block and improves the ablation outcomes in persistent atrial fibrillation (PeAF) patients. 0.78, p = .006).
Volta Medical has announced it has entered into a Joint Development Agreement with GE Healthcare to enhance arrhythmia procedures with artificial intelligence (AI)-driven electrophysiology technologies. Our mission to combat complex heart rhythm diseases relies on optimizing interoperability. The company has obtained U.S.
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:High-power short-duration ablation has shown impressive efficacy and safety for pulmonary vein isolation (PVI); however, initial efficacy results with very high power short-duration ablation were discouraging. rates between 90W and 50W.
Epicardial Marshall bundle (MB) are frequently utilized in left atrial tachycardias (LATs) post atrial fibrillation (AF) ablation with pulmonary vein isolation and substrate modification.
Backgroundwide antral pulmonary vein isolation (PVI) is effective for treating paroxysmal atrial fibrillation (PAF), although time-demanding. Procedural data and electrophysiology (EP) laboratory times were systematically collected and analyzed.
Pulsed field ablation (PFA) is a novel modality shown to be safe and efficient.1 1 PFA is conventionally used for pulmonary vein isolation (PVI), but interest has arisen in delivering linear lesions to the posterior wall2 and mitral isthmus.3 3 The durability of these lesion sets has not been well evaluated.
Abstract Introduction Carina breakthrough (CB) at the right pulmonary vein (RPV) can occur after circumferential pulmonary vein isolation (PVI) due to epicardial bridging or transient tissue edema. High-power short-duration (HPSD) ablation may increase the incidence of RPV CB.
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. We investigate whether additional linear ablation from the superior vena cava to the right atrial septum and cavotricuspid isthmus ablation improves the rhythm outcome of patients with persistent AF undergoing cryoballoon PVI (Cryo-PVI).METHODS:In
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Patients were randomly assigned to either the PVI+SVC ablation group or the PVI-only group. CONCLUSIONS:The addition of SVC ablation to PVI did not enhance freedom from atrial tachyarrhythmia at 12 months, and it led to increased complications. versus 72%;P=0.41).
Abstract Introduction Through systematic scientific rigor, the CLOSE guided workflow was developed and has been shown to improve pulmonary vein isolation durability. However, this technique was developed at a time when using power-controlled ablation catheters with conventional power ranges was the norm.
Pulsed-field ablation (PFA) is becoming increasingly relevant in the field of electrophysiology. Besides single-shot PFA devices for pulmonary vein isolation (PVI), point-by-point PFA is also gaining importance due to many possible applications. Data on the use is sparse, especially for atrial tachycardia (AT).
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. Background:Pulsed field ablation (PFA) has emerged as an alternative to radiofrequency ablation. A contact force–sensing catheter was used to focally deliver PFA/radiofrequency at the pulmonary veins and other predefined sites in the atria.
Abstract Background The newly introduced nonthermal pulsed field ablation (PFA) is a promising technology to achieve fast pulmonary vein isolation (PVI) with high acute success rates and good safety features. Data comparing PFA to VHPSD-PVI is lacking. Two tamponades occurred in the PFA while in VHPSD two pts suffered groin bleedings.
a company primarily focused on leveraging its novel and proprietary CellFX Nanosecond Pulsed Field Ablation (nsPFA) technology for the treatment of atrial fibrillation, announced the completion of the first five procedures in its first-in-human feasibility study with its novel CellFX nsPFA cardiac catheter. “We
After 12 months of follow-up, there was an 81% freedom of AF in general, which was significantly higher in patients treated with robotic magnetic navigation-guided radiofrequency ablation (RMN-RF). Abstract Introduction Pulmonary vein isolation (PVI) is a pivotal part of ablative therapy for atrial fibrillation (AF).
ABSTRACT Background Ultra-low temperature cryoablation (ULTC) is a technique designed to rapidly cool cardiac tissue to extremely low temperatures, enabling the creation of ablation lesions for the treatment of atrial fibrillation (AF). Arrhythmia outcomes after repeat ablation were evaluated.
Abstract Introduction Although first-pass isolation (FPI) of the pulmonary vein (PV) has been suggested as a marker for PV isolation (PVI) durability, it has not been confirmed. Non-PV atrial fibrillation (AF) triggers were the main target in patients without PV reconnection in the second ablation procedure, but the outcome was unclear.
In this study, AEPVR (acute epicardial pulmonary vein reconnection) was differentiated in characteristics from endocardial conduction gap in acute PVR (left). We aimed to investigate the prevalence, locations, electrogram characteristics, and ablation parameters related to acute epicardial pulmonary vein reconnection (AEPVR).
We present the long-term outcome of catheter ablation (CA) and electrophysiological characteristics in HIV+ AF patients. During first procedure, all received isolation of pulmonary vein (PV) + posterior wall and superior vena cava. Among patients that underwent redo ablation non-PV triggers were higher in HIV group [93.5%
Abstract Introduction The impact of combining ablation index (AI)-guided and very high-power short-duration (vHPSD) ablation on procedural factors at the posterior wall near the esophagus is unclear. Methods Atrial fibrillation patients who underwent initial ablation using three-dimensional mapping were enrolled.
Abstract Introduction Pulsed field ablation (PFA) has emerged as an innovative technique for pulmonary vein isolation (PVI). Typically, a transeptal puncture (TSP) with a standard sheath precedes a switch to the larger diameter sheath in the left atrium.
This study investigated myocardial injury and inflammation following pulmonary vein isolation using (1) Standard radiofrequency ablation, (2) very high-power short-duration (vHPSD)-70W, (3) vHPSD-90W, and (4) pulsed-field ablation (PFA). Results Baseline characteristics were well-balanced between groups (age 63.1 ± 10.3
Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:Pulsed field ablation (PFA) is a promising treatment for atrial fibrillation. paroxysmal, and 58.5% deep sedation) were treated. One-year freedom from atrial arrhythmia was 80.2% (95% CI, 69.7%87.4%)
In this large substudy of the AWARE Trial, a high-power short-duration (HPSD) radiofrequency ablation strategy was found to be similarly effective as a low-power long-duration strategy with no difference in time to first recurrence of any AF lasting ≥30 s. The primary outcome was not statistically significant at 30.1% versus 22.2%
ABSTRACT Introduction The extensive use of pulsed field ablation (PFA) in clinical settings has unveiled new evidence suggesting potential involvement in red blood cell structural impairment resulting in hemolysis and potential acute kidney injury (AKI).
Abstract Introduction During atrial fibrillation ablation (AFA), achievement of first pass isolation (FPI) reflects effective lesion formation and predicts long-term freedom from arrhythmia recurrence. We aim to determine the clinical and procedural predictors of pulmonary vein FPI.
This study of 16 patients with persistent left superior vena cava (PLSVC) undergoing atrial fibrillation ablation shows a 66.7% identification rate of PLSVC-related triggers and an 85% success rate in acute isolation or targeted ablation. However, a 46.7% The primary endpoints were procedural safety and AF recurrence postablation.
Pulsed field ablation (PFA) may overcome the disadvantages of thermal energy and improve both ablation efficacy and safety. Coronary vasospasm occurred (and quickly resolved after injection of nitroglycerin) in one patient during additional ablation of a focal atrial tachycardia at the coronary sinus ostium.
FAAM ablation successfully decreased the recurrence rate of atrial tachyarrhythmia compared with conventional non-PV foci ablation. Abstract Introduction Treatment of recurrent atrial fibrillation (AF) is sometimes challenging due to non-pulmonary vein (PV) foci. The RHYTHMIA system was used to perform all the procedures.
Abstract Introduction Cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to a pulmonary vein isolation has been expected to improve the clinical outcomes post-atrial fibrillation (AF) ablation. Results Complete LA roof line conduction block was obtained in 767 patients (92.0%) solely by CBA (Group A).
Methods and Results This case report discusses a 65-year-old man who had previously undergone pulmonary vein isolation (PVI) and cavo-tricuspid isthmus ablation for atrial fibrillation before ASD closure, respectively. He developed atrial tachycardia (AT) and underwent catheter ablation.
ABSTRACT Introduction Pulmonary vein (PV) restenosis develops with reported incidence rates of up to 50%. Method and Results A 54-year-old man with long history of atrial fibrillations developed PVS secondary to multiple radiofrequency ablation procedures. Balloon angioplasty seems to be the widely preferred treatment of choice.
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