Acute durability of cavotricuspid isthmus block after pulsed electric field ablation: randomized comparison of two pentaspline catheter configurations (SECTION trial)

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F25%3A00085887" target="_blank" >RIV/00023001:_____/25:00085887 - isvavai.cz</a>

Alternative codes found

RIV/60076658:12110/25:43910522 RIV/61988987:17110/25:A2603DG7 RIV/00216208:11110/25:10503232 RIV/00216208:11130/25:10503232 RIV/00064165:_____/25:10503232

Result on the web

<a href="https://academic.oup.com/europace/article/27/10/euaf234/8262584" target="_blank" >https://academic.oup.com/europace/article/27/10/euaf234/8262584</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/europace/euaf234" target="_blank" >10.1093/europace/euaf234</a>

Result language

angličtina

Original language name

Acute durability of cavotricuspid isthmus block after pulsed electric field ablation: randomized comparison of two pentaspline catheter configurations (SECTION trial)

Original language description

Aims: Cavotricuspid isthmus (CTI) ablation is commonly performed alongside catheter ablation of atrial fibrillation (AF). However, the acute efficacy of the CTI ablation using the pentaspline catheter and pulsed electric field (PEF) energy has not been systematically evaluated. This randomized study assessed the acute efficacy and extent of haemolysis associated with CTI ablation when performed using two different configurations of the pentaspline catheter. Methods and results: A total of 178 patients (age 65 +/- 10 years, 66% of males) undergoing PEF ablation of the CTI in conjunction with AF ablation were randomly assigned to receive ablation using either the basket configuration (n = 95) or the flower configuration (n = 83) of the pentaspline catheter. The CTI ablation was performed before left atrial ablation. It was guided by intracardiac echocardiography, and bidirectional block was confirmed by pacing manoeuvres. Venous blood samples to assess haemolytic biomarkers were collected before and immediately after the CTI ablation. The groups were broadly comparable in baseline characteristics. The flower group demonstrated superior procedural efficiency, with fewer applications required to achieve a CTI block (3.4 +/- 3.1 vs. 8.0 +/- 4.1, P &lt; 0.001), a shorter time to block (96 +/- 289 vs. 177 +/- 192 s, P &lt; 0.001), and fewer total applications (10.1 +/- 3.4 vs. 13.3 +/- 5.1, P &lt; 0.001). Acute reconduction occurred in 20% of cases overall, but was significantly lower in the flower group (6% vs. 32%, P &lt; 0.001; hazard ratio: 0.14, 95% confidence interval: 0.06-0.40). Haemolysis was notably lower in the flower group, with significantly less post-procedural free haemoglobin (154 +/- 112 vs. 210 +/- 115 mg/L, P &lt; 0.001). One case of transient ST elevations occurred in the flower group without clinical consequence. Conclusion: Pulsed electric field ablation of the CTI using the flower configuration of the pentaspline catheter demonstrated higher acute efficacy in achieving CTI block and a more favourable safety profile regarding haemolysis compared to the basket configuration. This is likely due to the larger footprint and improved tissue contact of all electrodes, minimizing the leakage of PEF energy into the blood pool. [GRAPHICS]

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

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

Publication year

2025

Confidentiality

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

Name of the periodical

Europace

ISSN

1099-5129

e-ISSN

1532-2092

Volume of the periodical

27

Issue of the periodical within the volume

10

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

"art. no. euaf234"

UT code for WoS article

001591064500001

EID of the result in the Scopus database

2-s2.0-105018344824