Pulsed-field- vs. cryoballoon-based pulmonary vein isolation: lessons from repeat procedures

• DOI: 10.1093/europace/euae221
• Publication Date: 2024-08-22T02:30:43Z
• Authors: Marc D Lemoine; Julius Obergassel; Sandro Jaeckle; Moritz Nies; Sophia Taraba; Celine Mencke; Jan Rieß; Ilaria My; Laura Rottner; Fabian Moser; Djemail Ismaili; Bruno Reißmann; Feifan Ouyang; Paulus Kirchhof; Andreas Rillig; Andreas Metzner
• Keywords: Atrial tachycardia

Abstract Aims Pulsed-field ablation (PFA) is an emerging technology to perform pulmonary vein isolation (PVI). Initial data demonstrated high safety and efficacy. Data on long-term PVI durability reconduction patterns in comparison established energy sources for are scarce. We compare findings repeat procedures after a first PFA cryoballoon (CBA) based PVI. Methods result A total of 550 consecutively enrolled patients underwent or CBA index Repeat ablations with symptomatic atrial arrhythmia recurrences were analysed. 22/191 (12%) PFA-PVI 44/359 CBA-PVI ablation. Reconduction any (PV) was detected by multipolar spiral mapping catheter at each PV careful evaluation potentials 3D-mapping 16/22 (73%) 33/44 (75%) (P = 1.000). Of 82 initially isolated PVs PFA-PVI, 31 (38%) reconducting; 169 CBA-PVI, 63 (37%) reconducting 0.936). Clinical tachycardia occurred similarly (5/22; 23%) (7/44; 16%; P 0.515). Roof lines set more often PFA- (8/22; 36%) compared (5/44; 11%; 0.023). procedure duration [PFA: 87 (76, 123) min; CBA: 93 (75, 128) 0.446] similar fluoroscopy time 11 (9, 14) (8, 0.739] equal between groups Conclusion During previous CBA-based PVI, electrical PV-reconduction rates similar.