PULSED FIELD ABLATION IN OVER 2 K PATIENTS FOR PAROXYSMAL AND PERSISTENT ATRIAL FIBRILLATION IN SINGLE CENTER.

P. Neužil, J. Petrů, L. Šedivá, J. Škoda, M. Chovanec, P. Hála, M. Janotka, V. Lekešová, M. Funasako (Praha)
Tématický okruh: Poruchy rytmu, kardiostimulace
Typ: Ústní sdělení - lékařské, XXXII. Sjezd ČKS

Background:  Pulsed field ablation (PFA) with adapted sub-second electric – fields create pores in cell membranes – caused irreversible electroporation. Analysis conteined Farawave™ catheter PFA in single center high-volume center.
Methods: Ablation was performed using proprietary biphasic bipolar PFA waveform with in two diferent configurations: basket and flower for PV isolation (in 2+2 after rotating strategy), flower for left atrium posterior wall, mitral isthmus and cavo-tricuspid isthmus ablation. In the case of posterior wall ablation Farawave™ catheter was navigated by integration with CT and fluoroscopy system. The index procedure was performed in deep sedation,intravenous atropin was administered prior PFA application.
Results: 2.152 patients (1354 M/ 798 F), average age was 66,7 ±11,3 years; BMI 28,9± 7,9 underwent procedure for paroxysmal AF (1123 ), for persistent AF (853 ), long-standing persistent AF (168) and atrial tachycardia (8). Mean LV EF was 58,2±9,5%. All PVs were acutely isolated with PFA ≤ 3,2 min elapsed delivery/patient, skin-to-skin procedure time for paroxysmal AF was 34,8 ± 8,9 min and fluoroscopy time of 4,96 ± 6,59 min. For persistent and long-standing persistent AF skin-to-skin procedure time was 59,7 ± 17,8 68,8 ± 21,8 min respectively and fluoroscopy time was 6,4±5,23 min and 6,82 ± 4,4 min. For AT the total procedure time was 72,4±23,5 min. and fluoroscopy 7,2 ± 4,8 min. PVI was done in 2.131 pts, posterior LA isolation in 1.371 pts, mitral isthmus PFA in 431 and CTI in 650 pts. During mean time follow-up time of 487 days the freedom from arrhythmia was 88.1 ± 4,8 % on Holters and ECGs for all types of atrial arrhythmias.
Conclusion: In these over 2.000 patients underwent PFA as a real clinical practise for all types of AF and ATs, with excellent durability and safety.