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Safety and Effectiveness of Pulsed Field Ablation for Atrial Fibrillation in Patients With Heart Failure.
Turagam, Mohit K; Neuzil, Petr; Schmidt, Boris; Reichlin, Tobias; Neven, Kars; Metzner, Andreas; Hansen, Jim; Blaauw, Yuri; Maury, Philippe; Arentz, Thomas; Sommer, Philipp; Anic, Ante; Anselme, Frederic; Boveda, Serge; Deneke, Tom; Willems, Stephan; van der Voort, Pepijn; Tilz, Roland; Funasako, Moritoshi; Scherr, Daniel; Wakili, Reza; Steven, Daniel; Kautzner, Josef; Vijgen, Johan; Jais, Pierre; Petru, Jan; Chun, Julian; Roten, Laurent; Füting, Anna; Lemoine, Marc D; Ruwald, Martin; Mulder, Bart A; Rollin, Anne; Lehrmann, Heiko; Fink, Thomas; Jurisic, Zrinka; Chaumont, Corentin; Adelino, Raquel; Nentwich, Karin; Gunawardene, Melanie; Ouss, Alexandre; Heeger, Christian-Hendrik; Manninger, Martin; Bohnen, Jan-Eric; Sultan, Arian; Peichl, Petr; Koopman, Pieter; Derval, Nicolas; Kueffer, Thomas; Reinsch, Nico.
Afiliación
  • Turagam MK; Icahn School of Medicine at Mount Sinai, New York, New York, USA.
  • Neuzil P; Cardiology Department, Na Homolce Hospital, Homolka Hospital, Prague, Czech Republic.
  • Schmidt B; Medizinisches Versorgungszentrum CCB Frankfurt und Main-Taunus GbR, Frankfurt, Germany.
  • Reichlin T; Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland.
  • Neven K; Department of Medicine, Witten/Herdecke University, Witten, Germany; Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany.
  • Metzner A; University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Hansen J; Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark.
  • Blaauw Y; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Maury P; Department of Cardiology, University Hospital Rangueil, Toulouse, France; Institute of Metabolic and Cardiovascular Diseases, INSERM UMR 1297, Toulouse, France.
  • Arentz T; Department of Cardiology and Angiology, Medical Center and Faculty of Medicine, University of Freiburg, Germany.
  • Sommer P; Clinic for Electrophysiology, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Anic A; Department for Cardiovascular Diseases, University Hospital Center Split, Split, Croatia.
  • Anselme F; Department of Cardiology, Rouen Hospital, Rouen, France.
  • Boveda S; Heart Rhythm Department, Clinique Pasteur, Toulouse, France; Universitair Ziekenhuis, Brussels, Belgium.
  • Deneke T; Heart Center Bad Neustadt, Rhoen-Clinic Campus Bad Neustadt, Bad Neustadt an der Saale, Germany.
  • Willems S; Asklepios Hospital St Georg, Hamburg, Germany.
  • van der Voort P; Catharina Ziekenhuis, Eindhoven, the Netherlands.
  • Tilz R; University Heart Center Lübeck, Department of Rhythmology, University Hospital Schleswig-Holstein, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.
  • Funasako M; Cardiology Department, Na Homolce Hospital, Homolka Hospital, Prague, Czech Republic; Neuron Medical, Brno, Czech Republic.
  • Scherr D; Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Wakili R; Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Duisburg, Germany.
  • Steven D; Department for Electrophysiology, Heart Center University Hospital of Cologne, Cologne, Germany.
  • Kautzner J; IKEM-Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  • Vijgen J; Department of Cardiology, Jessa Hospitals, Hasselt, Belgium.
  • Jais P; L'institut Des Maladies Du Rythme Cardiaque, LIRYC, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
  • Petru J; Cardiology Department, Na Homolce Hospital, Homolka Hospital, Prague, Czech Republic.
  • Chun J; Medizinisches Versorgungszentrum CCB Frankfurt und Main-Taunus GbR, Frankfurt, Germany.
  • Roten L; Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland.
  • Füting A; Department of Medicine, Witten/Herdecke University, Witten, Germany; Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany.
  • Lemoine MD; University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Ruwald M; Department of Cardiology, Herlev-Gentofte University Hospital, Hellerup, Denmark.
  • Mulder BA; Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
  • Rollin A; Department of Cardiology, University Hospital Rangueil, Toulouse, France.
  • Lehrmann H; Department of Cardiology and Angiology, Medical Center and Faculty of Medicine, University of Freiburg, Germany.
  • Fink T; Clinic for Electrophysiology, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Jurisic Z; Department for Cardiovascular Diseases, University Hospital Center Split, Split, Croatia.
  • Chaumont C; Department of Cardiology, Rouen Hospital, Rouen, France.
  • Adelino R; Heart Rhythm Department, Clinique Pasteur, Toulouse, France; Universitair Ziekenhuis, Brussels, Belgium.
  • Nentwich K; Heart Center Bad Neustadt, Rhoen-Clinic Campus Bad Neustadt, Bad Neustadt an der Saale, Germany.
  • Gunawardene M; Asklepios Hospital St Georg, Hamburg, Germany.
  • Ouss A; Catharina Ziekenhuis, Eindhoven, the Netherlands.
  • Heeger CH; University Heart Center Lübeck, Department of Rhythmology, University Hospital Schleswig-Holstein, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.
  • Manninger M; Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Bohnen JE; Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Duisburg, Germany.
  • Sultan A; Department for Electrophysiology, Heart Center University Hospital of Cologne, Cologne, Germany.
  • Peichl P; IKEM-Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  • Koopman P; Department of Cardiology, Jessa Hospitals, Hasselt, Belgium.
  • Derval N; L'institut Des Maladies Du Rythme Cardiaque, LIRYC, CHU Bordeaux, University of Bordeaux, Bordeaux, France.
  • Kueffer T; Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland.
  • Reinsch N; Department of Medicine, Witten/Herdecke University, Witten, Germany; Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany.
JACC Clin Electrophysiol ; 2024 May 18.
Article en En | MEDLINE | ID: mdl-38864809
ABSTRACT

BACKGROUND:

Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).

OBJECTIVE:

This study sought to assess the outcomes of pulsed field ablation (PFA) in HF.

METHODS:

MANIFEST-PF (Multi-National Survey on the Methods, Efficacy, and Safety on the Post-Approval Clinical Use of Pulsed Field Ablation) is a multicenter, patient-level registry of consecutive patients undergoing PFA for paroxysmal AF or persistent AF (PerAF). In this substudy, patients were stratified as no history of HF (no-HF), HF with preserved EF (HFpEF) (left ventricular EF of ≥50%) or HF with reduced/mildly reduced EF (HFmr/rEF) (left ventricular EF of <50%). The primary effectiveness and safety endpoints were freedom from documented atrial arrhythmias lasting ≥30 seconds and major adverse events, respectively.

RESULTS:

Of the 1,381 patients, 85% (n = 1,174) were no-HF, 6.2% (n = 87) were HFpEF, and 8.6% (n = 120) were HFmr/rEF. No-HF patients had less PerAF than patients with HF (P < 0.001), with no difference between HF subtypes (P = >0.99). The 1-year freedom from atrial arrhythmia was significantly higher in no-HF patients than in those with HFpEF or HFmr/rEF (79.9%, 71.3%, and 67.5%, respectively; P < 0.001) but similar between patients with HFmr/rEF and HFpEF (P = 0.26). However, there was no significant difference in freedom from atrial arrhythmia among patients with no-HF vs HFpEF vs HFmr/rEF for those with paroxysmal AF (82.8%, 82.4%, and 71.7%, respectively; P = 0.09) and PerAF (73.3%, 64.2%, and 64.9%, respectively; P = 0.14). Major adverse event rates were similar between the no-HF, HFpEF, and HFmr/rEF groups (1.9%, 0%, and 2.5%, respectively).

CONCLUSIONS:

PFA appears to be potentially safe and effective in AF patients with HF. Freedom from atrial arrhythmia post-PFA was higher in patients without a history of HF, with no significant difference between HF subtypes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Clin Electrophysiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JACC Clin Electrophysiol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos