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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10489056

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/LX22NPO5104" target="_blank" >LX22NPO5104: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

Journal of cardiovascular electrophysiology

ISSN

1045-3873

e-ISSN

1540-8167

Svazek periodika

36

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

256-265

Kód UT WoS článku

001363906900001

EID výsledku v databázi Scopus

2-s2.0-85210100629