Pulsed Field Ablation-Based Pulmonary Vein Isolation Using a Simplified Single-Access Single-Catheter Approach　― The Fast and Furious PFA Study ―

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  • Tilz Roland R.
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck
  • Vogler Julia
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Kirstein Bettina
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Eitel Charlotte
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Phan Huong-Lan
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Popescu Sorin Ștefan
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Hatahet Sascha
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Große Niels
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Subin Behnam
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Lopez Lisbeth Delgado
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Kuck Karl-Heinz
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein
  • Heeger Christian-H.
    Department of Rhythmology, University Heart Center Lübeck, University Hospital Schleswig-Holstein German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck

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<p>Background: Pulsed field ablation (PFA) is a non-thermal energy source with promising safety and efficacy advantages. We aimed to develop a convenient, safe, effective and fast method of pulmonary vein isolation (PVI) utilizing a penta-spline PFA catheter via a single femoral vein and a venous closure system.</p><p>Methods and Results: Consecutive patients (n=50; mean age: 63.6±10.7 years, 38% female) presenting with AF (paroxysmal AF: 56%) underwent first-time PVI via PFA. A single ultrasound-guided femoral vein puncture and a single transseptal puncture were used. After PVI using the penta-spline PFA catheter, extra pulse trains were added to the posterior wall for wide antral circumferential ablation. A venous closure system was used and a Donati suture was performed. The pressure bandage was removed after 1 h. A total of 196 PVs were identified and isolated with PFA only. The mean procedural time was 27.4±6.6 min, and the mean dwelling time was 14.4±5.5 min. Time to ambulation was 3.3±3.1 h. No severe complications occurred. During a mean follow-up of 6.5±2.1 months, 41/50 patients (82%) remained in sinus rhythm.</p><p>Conclusions: The combination of a single venous puncture, single transseptal puncture approach using PFA and vascular closure device resulted in a 100% rate of acute PVI and an extraordinarily fast procedure and time to ambulation. The rate of periprocedural complications was low.</p>

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  • Circulation Journal

    Circulation Journal 87 (12), 1722-1726, 2023-11-24

    一般社団法人 日本循環器学会

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