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Atrial fibrillation ablation during hospitalization for acute heart failure: feasibility and role of pulsed field ablation

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F25%3A00085322" target="_blank" >RIV/00023001:_____/25:00085322 - isvavai.cz</a>

  • Alternative codes found

    RIV/00216208:11110/25:10489056

  • Result on the web

    <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16507" target="_blank" >https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16507</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1111/jce.16507" target="_blank" >10.1111/jce.16507</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Atrial fibrillation ablation during hospitalization for acute heart failure: feasibility and role of pulsed field ablation

  • Original language description

    Introduction: Atrial fibrillation (AF) can cause or aggravate heart failure (HF). Catheter ablation (CA) is an effective treatment for AF. This study focused on the feasibility and outcomes of emergent AF ablation performed during hospitalization for acute HF. Methods and Results: We retrospectively investigated patients who underwent emergent CA for AF during hospitalization for acute HF in 2018-2024. Arrhythmia recurrence was the primary endpoint. The combination of arrhythmia recurrence, HF hospitalization, and all-cause death was the secondary endpoint. Patients were censored 1 year after the index procedure. We included 46 patients, 35% females, with median age of 67 [interquartile rage: 61, 72] years and left ventricular ejection fraction (LVEF) of 25 [23, 28]%. Thermal CA was performed in 14 patients, and pulsed field ablation (PFA) in 32 patients. Procedure time was significantly shorter with PFA compared to thermal CA (77 [57, 91] vs. 166 [142, 200] minutes, p &lt; 0.001). Fluoroscopy time was longer with PFA (9.5 [7.6, 12.0] vs. 3.9 [2.9, 6.0] minutes, p &lt; 0.001), with a borderline trend towards higher radiation dose (75 [53, 170] vs. 50 [30, 94] mu Gy.m(2), p = 0.056). Extrapulmonary ablation was frequent (86% and 84% for thermal CA and PFA, p &gt; 0.9). The estimated freedom from the primary endpoint was 79% after PFA and 64% after thermal CA (p = 0.44). The estimated freedom from the secondary endpoint was 76% after PFA and 57% after thermal CA (p = 0.43). LVEF improved by 24% +/- 2% (p &lt; 0.001) in patients with the first manifestation of HF and by 14% +/- 4% (p = .004) in patients with decompensated HF diagnosed earlier. Conclusions: Emergent CA of AF during acute HF hospitalization is safe and associated with improved LVEF and good clinical outcomes. In the PFA era, the rate of these procedures is progressively increasing as they are readily available and easy to perform compared to thermal ablation.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

    <a href="/en/project/LX22NPO5104" target="_blank" >LX22NPO5104: National Institute for Research of Metabolic and Cardiovascular Diseases</a><br>

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2025

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Journal of cardiovascular electrophysiology

  • ISSN

    1045-3873

  • e-ISSN

    1540-8167

  • Volume of the periodical

    36

  • Issue of the periodical within the volume

    1

  • Country of publishing house

    US - UNITED STATES

  • Number of pages

    10

  • Pages from-to

    256-265

  • UT code for WoS article

    001363906900001

  • EID of the result in the Scopus database

    2-s2.0-85210100629