Repeat procedures after pulsed field ablation for atrial fibrillation: MANIFEST-REDO study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023884%3A_____%2F25%3A00010189" target="_blank" >RIV/00023884:_____/25:00010189 - isvavai.cz</a>

Alternative codes found

RIV/00023001:_____/25:00085782

Result on the web

<a href="https://academic-oup-com.ezproxy.lib.cas.cz/europace/article/27/8/euaf012/7958418?login=true&token=eyJhbGciOiJub25lIn0.eyJleHAiOjE3NzMzMTI3NTIsImp0aSI6IjRhNGRmZTYyLWQyYmMtNGVmZC05ZmQ2LTdkNTkzNDZlZDE3YSJ9" target="_blank" >https://academic-oup-com.ezproxy.lib.cas.cz/europace/article/27/8/euaf012/7958418?login=true&token=eyJhbGciOiJub25lIn0.eyJleHAiOjE3NzMzMTI3NTIsImp0aSI6IjRhNGRmZTYyLWQyYmMtNGVmZC05ZmQ2LTdkNTkzNDZlZDE3YSJ9</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/europace/euaf012" target="_blank" >10.1093/europace/euaf012</a>

Result language

angličtina

Original language name

Repeat procedures after pulsed field ablation for atrial fibrillation: MANIFEST-REDO study

Original language description

Aims Initial clinical studies of pulsed field ablation (PFA) to treat atrial fibrillation (AF) indicated a >90% durability rate of pulmonary vein isolation (PVI). However, these studies were largely conducted in single centres and involved a limited number of operators. We aimed to describe the electrophysiological findings and outcomes in patients undergoing repeat ablation after an initial PF ablation for AF. Methods and results In the MANIFEST-REDO study, we investigated patients who underwent repeat ablation due to clinical recurrence-AF or atrial tachycardia (AT)-following first-ever PVI with a pentaspline PFA catheter (Farawave, Boston Scientific Inc.). At 22 centres, 427 patients (age 64 +/- 11 years; 37% female) were included. Of note, the recurrent arrhythmia leading to the repeat ablation was paroxysmal AF (51%), persistent AF (30%), or AT (19%). At the repeat procedure, the PV reconnection rates were 30% (left superior pulmonary vein), 28% (left inferior pulmonary vein), 33% (right superior pulmonary vein), and 32% (right inferior pulmonary vein). In 45% of patients, all PVs were durably isolated at the beginning of the repeat procedure, with the previous use of any imaging or mapping modality being univariately associated with durable PVI. After a post-redo follow-up period of 284 (90-366) days, the primary effectiveness endpoint (freedom from documented AF/AT lasting >= 30 s after 3-month blanking without class I/III antiarrhythmic drugs or symptoms) was achieved in 65% of patients, with significant differences between groups (PAF 65% vs. PersAF 56% vs. AT 76%; P = 0.04). Persistent AF as recurrent arrhythmia after the initial PFA ablation predicted AT/AF recurrence after repeat ablation [hazard ratio 1.241 (95% confidence interval 1.534-1.005); P = 0.045]. The procedural complication rate was 2.8%. Conclusion In repeat procedures for AF/AT performed after an index procedure with PFA for AF, PV reconnections are not uncommon. Repeat procedures can be performed safely and with an acceptable subsequent success rate.

Czech name

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Czech description

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Type

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

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

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

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Volume of the periodical

27

Issue of the periodical within the volume

8

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

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UT code for WoS article

001550755600001

EID of the result in the Scopus database

2-s2.0-105013212688