دورية أكاديمية
National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety.
| العنوان: | National workflow experience with pulsed field ablation for atrial fibrillation: learning curve, efficiency, and safety. |
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| المؤلفون: | Bisignani A; Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Via di Ponte Quattro Capi 39, 00186, Rome, Italy. abisignani@hotmail.it., Schiavone M; Monzino Cardiological Center, Milan, Italy., Solimene F; Montevergine Clinic, Mercogliano, AV, Italy.; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy., Dello Russo A; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.; Department of Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy., Filannino P; Maria Cecilia Hospital, Cotignola, RA, Italy., Magnocavallo M; Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Via di Ponte Quattro Capi 39, 00186, Rome, Italy., Tondo C; Monzino Cardiological Center, Milan, Italy., Schillaci V; Montevergine Clinic, Mercogliano, AV, Italy., Casella M; Department of Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy.; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy., Petretta A; Maria Cecilia Hospital, Cotignola, RA, Italy., Rossi P; Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Via di Ponte Quattro Capi 39, 00186, Rome, Italy., Fassini G; Monzino Cardiological Center, Milan, Italy., Rossillo A; San Bortolo Hospital, Vicenza, Italy., Maggio R; Degli Infermi Hospital, Rivoli, TO, Italy., Themistoclakis S; Dell'Angelo Hospital, Mestre, VE, Italy., Pandozi C; San Filippo Neri Hospital, Rome, Italy., Polselli M; Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Via di Ponte Quattro Capi 39, 00186, Rome, Italy., Tundo F; Monzino Cardiological Center, Milan, Italy., Arestia A; Montevergine Clinic, Mercogliano, AV, Italy., Compagnucci P; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy.; Department of Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy., Valente Perrone A; Boston Scientific, Milan, Italy., Malacrida M; Boston Scientific, Milan, Italy., Iacopino S; Maria Cecilia Hospital, Cotignola, RA, Italy., Bianchi S; Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola, Via di Ponte Quattro Capi 39, 00186, Rome, Italy. |
| المصدر: | Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2024 May 30. Date of Electronic Publication: 2024 May 30. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Netherlands NLM ID: 9708966 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-8595 (Electronic) Linking ISSN: 1383875X NLM ISO Abbreviation: J Interv Card Electrophysiol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Amsterdam : Springer Original Publication: Norwell, MA : Kluwer Academic Publishers, c1997- |
| مستخلص: | Background: Recent data on pulsed field ablation (PFA) for atrial fibrillation (AF) ablation suggest a progressive reduction in procedural times. Real-world data regarding the relationship between the learning curve of PFA and clinical outcomes are scarce. The objective was to evaluate the PFA learning curve and its impact on acute outcomes. Methods: Consecutive patients undergoing AF ablation with the FARAPULSE™ PFA system were included in a prospective, non-randomized multicenter study. Procedural times were stratified on the operators' learning curve. Comparative analysis of skin-to-skin time was conducted with radiofrequency (RF) and cryoablation (CB) pulmonary vein isolation (PVI) procedures performed by the same operators in the previous year. Results: Among 752 patients, 35.1% were females, and 66.9% had paroxysmal AF; mean age was 62.2 ± 10 years. A total of 62.5% of procedures were performed by operators with > 20 PFA procedures. Both time to PVI (25.6 ± 10 min vs 16.5 ± 8, p < 0.0001) and fluoroscopy time (19.8 ± 8 min vs 15.9 ± 8 min, p = 0.0045) significantly improved after 10 associated with consistent linear trend towards procedural time reduction (R 2 0.92-0.68 across various procedural metrics). Current PFA skin-to-skin time was lower than the historical skin-to-skin one in 217 (62.4%) procedures; it was similar in 112 (32.2%) cases and higher than the historical skin-to-skin one in 19 (5.5%). No major complications were reported. Conclusions: In this nationwide multicentric experience, the novel PFA system proved to be fast, safe, and acutely effective in both paroxysmal and persistent AF patients. The learning curve appears to be rapid, as improvements in procedural parameters were observed after only a few procedures. Clinical Trial Registration: Advanced TecHnologies For SuccEssful AblatioN of AF in Clinical Practice (ATHENA). URL: http://clinicaltrials.gov/ Identifier: NCT05617456. (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Atrial fibrillation; Clinical practice; Electroporation; Learning curve; Pulsed-field ablation |
| سلسلة جزيئية: | ClinicalTrials.gov NCT05617456 |
| تواريخ الأحداث: | Date Created: 20240530 Latest Revision: 20240530 |
| رمز التحديث: | 20240530 |
| DOI: | 10.1007/s10840-024-01835-6 |
| PMID: | 38814525 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1572-8595 |
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| DOI: | 10.1007/s10840-024-01835-6 |