Academic Journal
Comparing pulsed field electroporation and radiofrequency ablation for the treatment of atypical atrial flutter
| Τίτλος: | Comparing pulsed field electroporation and radiofrequency ablation for the treatment of atypical atrial flutter |
|---|---|
| Συγγραφείς: | Azevedo, S, Coutinho Santos, I, Almeida Carvalho, R, Gomes, D, Costa, H, Miguel Rocha Rodrigues, G, Matos, D, Carmo, J, Moscoso Costa, F, Galvao Santos, P, Carmo, P, Cavaco, D, Bello Morgado, F, Adragao, P |
| Πηγή: | Europace ; volume 28, issue Supplement_1 ; ISSN 1099-5129 1532-2092 |
| Στοιχεία εκδότη: | Oxford University Press (OUP) |
| Έτος έκδοσης: | 2026 |
| Περιγραφή: | Introduction Atypical atrial flutter (AAFL) comprises macro–reentrant atrial tachycardias not dependent on the cavotricuspid isthmus, often occurring after prior atrial ablation or in the context of atrial remodeling. Catheter ablation is the cornerstone of definitive rhythm control. High-power short-duration radiofrequency (HPSD-RF) and non-thermal pulsed field ablation (PFA) have recently emerged as novel energy modalities with potential advantages in procedural safety and efficiency. While both have been extensively evaluated in atrial fibrillation, evidence in atypical flutter is limited. This study aimed to compare procedural characteristics, acute efficacy, and mid-term outcomes between PFA and conventional RF ablation for AAFL. Methods This single-center retrospective study included 91 consecutive patients who underwent AAFL ablation between January 2023 and September 2025 (mean age 70 ± 12 years; 46% female). Prior atrial fibrillation ablation had been performed in 42% of patients. All procedures were performed using the CARTO 3D electroanatomical mapping system. Efficacy was defined as arrhythmia termination of atypical flutter during energy delivery. Recurrence was defined as any documented episode of atrial fibrillation or atypical atrial flutter detected on ECG, Holter monitoring, or clinical records during follow-up. Median follow-up duration was 13 months (IQR 6–21). Results Acute procedural success was high and comparable between groups (PFA 84.4% vs. RF 85.5%; p = 0.89). The mean total procedure duration was numerically shorter with PFA (128 ± 165 min) compared with RF (154 ± 140 min), though not statistically significant (mean difference = 26 min; 95% CI –40 to 92; p = 0.44). After multivariate adjustment, no significant difference in procedural duration was observed. Fluoroscopy time was significantly longer with PFA (11.5 ± 6.6 min vs. 7.2 ± 6.2 min; mean difference = 4.3 min; 95% CI 1.3–7.4; p = 0.006), while radiation exposure was similar (PFA 154 ± 121 mGy vs. RF 127 ± 150 mGy; p = ... |
| Τύπος εγγράφου: | article in journal/newspaper |
| Γλώσσα: | English |
| DOI: | 10.1093/europace/euag105.978 |
| Διαθεσιμότητα: | https://doi.org/10.1093/europace/euag105.978 https://academic.oup.com/europace/article-pdf/28/Supplement_1/euag105.978/68620283/euag105.978.pdf |
| Rights: | https://creativecommons.org/licenses/by-nc/4.0/ |
| Αριθμός Καταχώρησης: | edsbas.BA2A4F85 |
| Βάση Δεδομένων: | BASE |
| FullText | Text: Availability: 0 CustomLinks: – Url: https://doi.org/10.1093/europace/euag105.978# Name: EDS - BASE (ns324271) Category: fullText Text: View record from BASE |
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| Items | – Name: Title Label: Title Group: Ti Data: Comparing pulsed field electroporation and radiofrequency ablation for the treatment of atypical atrial flutter – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Azevedo%2C+S%22">Azevedo, S</searchLink><br /><searchLink fieldCode="AR" term="%22Coutinho+Santos%2C+I%22">Coutinho Santos, I</searchLink><br /><searchLink fieldCode="AR" term="%22Almeida+Carvalho%2C+R%22">Almeida Carvalho, R</searchLink><br /><searchLink fieldCode="AR" term="%22Gomes%2C+D%22">Gomes, D</searchLink><br /><searchLink fieldCode="AR" term="%22Costa%2C+H%22">Costa, H</searchLink><br /><searchLink fieldCode="AR" term="%22Miguel+Rocha+Rodrigues%2C+G%22">Miguel Rocha Rodrigues, G</searchLink><br /><searchLink fieldCode="AR" term="%22Matos%2C+D%22">Matos, D</searchLink><br /><searchLink fieldCode="AR" term="%22Carmo%2C+J%22">Carmo, J</searchLink><br /><searchLink fieldCode="AR" term="%22Moscoso+Costa%2C+F%22">Moscoso Costa, F</searchLink><br /><searchLink fieldCode="AR" term="%22Galvao+Santos%2C+P%22">Galvao Santos, P</searchLink><br /><searchLink fieldCode="AR" term="%22Carmo%2C+P%22">Carmo, P</searchLink><br /><searchLink fieldCode="AR" term="%22Cavaco%2C+D%22">Cavaco, D</searchLink><br /><searchLink fieldCode="AR" term="%22Bello+Morgado%2C+F%22">Bello Morgado, F</searchLink><br /><searchLink fieldCode="AR" term="%22Adragao%2C+P%22">Adragao, P</searchLink> – Name: TitleSource Label: Source Group: Src Data: Europace ; volume 28, issue Supplement_1 ; ISSN 1099-5129 1532-2092 – Name: Publisher Label: Publisher Information Group: PubInfo Data: Oxford University Press (OUP) – Name: DatePubCY Label: Publication Year Group: Date Data: 2026 – Name: Abstract Label: Description Group: Ab Data: Introduction Atypical atrial flutter (AAFL) comprises macro–reentrant atrial tachycardias not dependent on the cavotricuspid isthmus, often occurring after prior atrial ablation or in the context of atrial remodeling. Catheter ablation is the cornerstone of definitive rhythm control. High-power short-duration radiofrequency (HPSD-RF) and non-thermal pulsed field ablation (PFA) have recently emerged as novel energy modalities with potential advantages in procedural safety and efficiency. While both have been extensively evaluated in atrial fibrillation, evidence in atypical flutter is limited. This study aimed to compare procedural characteristics, acute efficacy, and mid-term outcomes between PFA and conventional RF ablation for AAFL. Methods This single-center retrospective study included 91 consecutive patients who underwent AAFL ablation between January 2023 and September 2025 (mean age 70 ± 12 years; 46% female). Prior atrial fibrillation ablation had been performed in 42% of patients. All procedures were performed using the CARTO 3D electroanatomical mapping system. Efficacy was defined as arrhythmia termination of atypical flutter during energy delivery. Recurrence was defined as any documented episode of atrial fibrillation or atypical atrial flutter detected on ECG, Holter monitoring, or clinical records during follow-up. Median follow-up duration was 13 months (IQR 6–21). Results Acute procedural success was high and comparable between groups (PFA 84.4% vs. RF 85.5%; p = 0.89). The mean total procedure duration was numerically shorter with PFA (128 ± 165 min) compared with RF (154 ± 140 min), though not statistically significant (mean difference = 26 min; 95% CI –40 to 92; p = 0.44). After multivariate adjustment, no significant difference in procedural duration was observed. Fluoroscopy time was significantly longer with PFA (11.5 ± 6.6 min vs. 7.2 ± 6.2 min; mean difference = 4.3 min; 95% CI 1.3–7.4; p = 0.006), while radiation exposure was similar (PFA 154 ± 121 mGy vs. RF 127 ± 150 mGy; p = ... – Name: TypeDocument Label: Document Type Group: TypDoc Data: article in journal/newspaper – Name: Language Label: Language Group: Lang Data: English – Name: DOI Label: DOI Group: ID Data: 10.1093/europace/euag105.978 – Name: URL Label: Availability Group: URL Data: https://doi.org/10.1093/europace/euag105.978<br />https://academic.oup.com/europace/article-pdf/28/Supplement_1/euag105.978/68620283/euag105.978.pdf – Name: Copyright Label: Rights Group: Cpyrght Data: https://creativecommons.org/licenses/by-nc/4.0/ – Name: AN Label: Accession Number Group: ID Data: edsbas.BA2A4F85 |
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