What question did this study set out to answer?

This research aims to evaluate how long linear lesions created with a new catheter last after ablation techniques.

May 10, 2026Heart Rhythm0 citationsOpen Access

Durability of Atrial Linear Lesion Sets Using a Dual-energy Lattice-tip Catheter: Data from Invasive Remapping

MNMoritz Nies MVMaria Luisa Benesch Vidal IMIlaria My

Key Points

This research aims to evaluate how long linear lesions created with a new catheter last after ablation techniques.
Durability of linear lesions was assessed using remapping data from patients who had atrial ablation.

Structured PICO

Does a dual-energy lattice-tip catheter (PFA and RFA) create durable atrial linear lesions in patients undergoing atrial ablation?

Population

39 patients (from a cohort of 252) who previously underwent atrial ablation and had remapping data available, median age 74 years, 41% female, 77% persistent AF, 44% with concomitant AT. Indications for remapping were recurrent arrhythmias (36%) and left atrial appendage occlusion after previous LAA isolation (64%).

Intervention

Atrial linear lesion sets created with a dual-energy lattice-tip catheter allowing for pulsed field ablation (PFA) and radiofrequency ablation (RFA).

Outcome

Durability of de novo linear lesions sets (isolation/block) assessed via invasive remapping at median 46 days.surrogate

A dual-energy lattice-tip catheter provides durable mid-term block for posterior box, CTI, and roof lines, but suboptimal durability for anterior and mitral isthmus lines.

Abstract

BACKGROUND: Atrial linear lesion sets are commonly performed as adjunctive ablation to pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) and/or macro-reentrant atrial tachycardia (AT). Long-term durability of atrial linear lesion sets remains suboptimal with radiofrequency ablation (RFA) and current catheter designs. OBJECTIVE: We aimed to assess the durability of linear lesions created with a dual-energy lattice-tip catheter allowing for pulsed field ablation (PFA) and RFA. METHODS: The durability of de novo linear lesions sets was assessed via remapping data from patients who previously underwent atrial ablation. RESULTS: Remapping data were available in 39 of 252 (16%) patients after a median of 46 days (interquartile range IQR 30-167) following the initial ablation procedure (74 years IQR 61-78, 41% female, LVEF 60% IQR 45-60, CHADS-VA-Score 3 IQR 1-4, 77% persistent AF, 44% with concomitant AT). Indications for remapping were recurrent arrhythmias in 14 patients (36%) and left atrial appendage (LAA) occlusion after previous LAA isolation in 25 patients (64%). In total, 36 pulmonary veins (PVs), 6 roof lines, 10 posterior box lesions, 17 anterior lines, 13 mitral isthmus lines, and 7 cavotricuspid isthmus (CTI)-lines were re-assessed. 31 of 36 PVs (86%) and 54 of 71 linear lesions (76%) were durably isolated/blocked (roof lines: 6/6 100%; posterior box lesions: 10/10 100%; anterior lines: 9/17 (53%); mitral isthmus lines: 7/13 54%; CTI: 7/7 100%). CONCLUSION: A novel lattice-tip ablation catheter allowing for PFA and RFA creates durable mid-term posterior box, CTI, and roof lines. Durability of anterior and mitral isthmus lines remains suboptimal in this case series.

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