The VLCC pulsed-field ablation system caused significantly lower myocardial injury (hs-cTnT median 708 ng/L) compared to PCS and LCS systems (1672 and 1740 ng/L).
Does the variable-loop circular catheter PFA system reduce myocardial injury compared to pentaspline or loop catheter systems in patients undergoing pulmonary vein isolation?
The variable-loop circular catheter PFA system is associated with significantly less myocardial injury (measured by hs-cTnT release) compared to pentaspline and loop catheter systems during pulmonary vein isolation.
Absolute Event Rate: 0% vs 0%
Abstract Background Pulsed-field ablation (PFA), a novel non-thermal modality, was recently introduced and is now available with four different FDA approved systems from three different manufacturers. While multiple studies have evaluated individual PFA systems, data comparing different PFA systems are scarce, particularly regarding differences in lesion creation and myocardial injury. Purpose To assess releases of high-sensitivity cardiac Troponin-T (hs-cTnT) after PVI using three different PFA systems to characterize extent of myocardial injury. Methods The study enrolled consecutive patients undergoing PVI between August 2024 and December 2024 at a Swiss tertiary centre. Hs-cTnT levels were measured one day before and after the procedure. PFA was performed using a pentaspline catheter-system, a loop catheter-system and a variable-loop circular catheter. Results 95 patients were treated with PCS (54%), 40 patients with LCS (23%), and 40 patients with VLCC (23%), with a total of 175 patients (median age 68 60 - 75 years, 33% female). The median CHA2DS2-VA score was 2 1 - 3, left atrial diameter 40 36 - 45 mm and left ventricular ejection fraction 59 53 - 64 %. The standard PFA application protocols were followed. The number of applications per patient for PCS, LCS and VLCC PFA system were 34, 34, and 54 (18 ablations), respectively. Pre-interventional median hs-cTnT levels did not differ between the three groups (10 7 – 15, p=0.948 ng/L). Post-interventional median hs-cTnT levels were considerably higher in the PCS (1672 1180 - 2188 ng/L) and LCS group (1740 1364 - 2289 ng/L; p=0.563) compared to the VLCC group (708 471 - 1213 ng/L; p0.001, Figure). Conclusion In conclusion, we found that the VLCC system is associated with significantly lower myocardial injury compared to PCS and LCS. Further prospective studies are needed to determine whether this difference in myocardial injury corresponds to improved lesion durability and long-term clinical outcomes.Figure
Bruegger et al. (Sat,) ने एक अन्य रिपोर्ट की। VLCC पल्स्ड-फील्ड एब्लेशन सिस्टम ने PCS और LCS सिस्टम (1672 और 1740 ng/L) की तुलना में मायोकार्डियल चोट (hs-cTnT माध्य 708 ng/L) को काफी कम किया।