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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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]

Název v anglickém jazyce

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

Popis výsledku anglicky

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]

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

Europace

ISSN

1099-5129

e-ISSN

1532-2092

Svazek periodika

27

Číslo periodika v rámci svazku

10

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

9

Strana od-do

"art. no. euaf234"

Kód UT WoS článku

001591064500001

EID výsledku v databázi Scopus

2-s2.0-105018344824