Near-zero fluoroscopy workflow for pulmonary vein isolation in atrial fibrillation using a variable loop, 3D-integrated circular PFA catheter (Varipulse™): initial single-center experience with the first 35 patients

• DOI: 10.1007/s10840-025-01981-5
• Publication Date: 2025-02-03T12:07:21Z
• Authors: M. Borlich; S. Groschke; J. Wietgrefe; F. Witt; A. Paulssen; S. Fichtlscherer; A. Elsässer; H. Nef; L. Iden
• Keywords: Single Center; Isolation

Catheter ablation is a standard atrial fibrillation (AF) treatment, traditionally using radiofrequency (RF) or cryoablation, which carries the risk of damaging nearby structures. Pulsed field (PFA) offers partly tissue-selective energy application with minimal collateral damage. This study evaluated near-zero fluoroscopy workflow novel VARIPULSE™ catheter, combining advanced mapping for optimized PFA delivery and reduced radiation. Here, we investigate safety, efficiency, effectiveness this approach in first 35 patients treated. aimed to assess procedural characteristics, acute efficacy pulmonary vein isolation (PVI) catheter AF, while specifically evaluating minimize radiation exposure during procedure. Thirty-five consecutive paroxysmal persistent AF underwent catheter. Procedures were conducted under general anesthesia deep sedation. Key endpoints included isolation, total procedure time, left (LA) dwell time dose, safety outcomes, focus on assessing feasibility workflow. Thirty Field Ablation Patients had median age 70 years typical cardiovascular comorbidities, 54% presenting AF. Thirty-three (94%) normal ventricular systolic function (> 60%). The CHA2DS2-VA score was 2 (IQR 1–3.75). Sinus rhythm observed 66% cases at start. Median 0.8 min, 53 LA 38 dose 20.4 µGym2. Pulmonary achieved 100% without touch-up. No major complications occurred. system enables an efficient, nearly fluoroscopy-free simple, easily integrable electrophysiology lab. Complete all touch-ups, safe no complications. demonstrates potential widespread adoption technology