Pulsed-Field Ablation Does Not Worsen Baseline Pulmonary Hypertension Following Prior Radiofrequency Ablations.

Autor:	Mohanty S; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Della Rocca DG; Department of Cardiology, University Hospital, Brussels, Belgium., Torlapati PG; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Chierchia GB; Department of Cardiology, University Hospital, Brussels, Belgium., Dello Russo A; Department of Electrophysiology, Ospedali Riuniti, Ancona, Italy., Casella M; Department of Electrophysiology, Ospedali Riuniti, Ancona, Italy., Gianni C; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., MacDonald B; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Mayedo A; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., La Fazia VM; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Bassiouny M; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Gallinghouse GJ; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Burkhardt JD; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Horton R; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Al-Ahmad A; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA., Di Biase L; Department of Electrophysiology, Albert Einstein College of Medicine at Montefiore Hospital, New York, New York, USA., Pannone L; Department of Cardiology, University Hospital, Brussels, Belgium., de Asmundis C; Department of Cardiology, University Hospital, Brussels, Belgium., Natale A; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA; Department of Internal Medicine, Metro Health Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. Electronic address: dr.natale@gmail.com.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Mar; Vol. 10 (3), pp. 477-486. Date of Electronic Publication: 2023 Nov 22.
DOI:	10.1016/j.jacep.2023.11.005
Abstrakt:	Background: Studies have reported development of pulmonary hypertension (PH) secondary to reduced LA compliance following AF ablation. Objectives: This study aimed to compare the risk of worsening of baseline PH between non-paroxysmal AF patients undergoing pulsed-field ablation (PFA) and standard radiofrequency ablation (RFA). Methods: This multicenter study included 28 nonparoxysmal AF patients with PH undergoing a PFA-based ablation procedure after >1 failed RFA. A cohort of 28 AF patients with PH, scheduled for repeat RFA, 1:1 propensity-score matched using a multivariable logistic model, were used as the comparator group. Right heart catheterization and echocardiography were performed before and after the procedure to assess the pulmonary artery pressure (PAP). PH was defined as resting mean PAP of >20 mm Hg. Results: The baseline characteristics of the PFA and propensity-matched RFA groups were comparable. The mean PAP assessments at baseline, follow-up, and change from baseline were analyzed. The groups had comparable baseline mean pulmonary artery pressures (mPAP) (P = 0.177). After adjustment for baseline mPAP in an analysis of covariance model, the least-squares means change at 3 months after ablation was -1.71 ± 1.03 mm Hg and 19.67 ± 1.03 mm Hg in PFA and RFA, respectively (P <0.001). Conclusions: In this propensity-matched population, no worsening of mPAP was detected following pulsed-field ablation in patients with pre-existing PH undergoing a repeat procedure for recurrence. Competing Interests: Funding Support and Author Disclosures Dr Chierchia has received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific, and Acutus Medical. Dr Dello Russo has served as a consultant for Abbott Medical. Dr Burkhardt is a consultant for Biosense Webster and Stereotaxis. Dr Di Biase is a consultant for Biosense Webster, Boston Scientific, Stereotaxis, and St. Jude Medical; and has received speaker honoraria from Medtronic, Atricure, EPiEP, and Biotronik. Dr de Asmundis has received research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips, and Acutus; and compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Livanova, Boston Scientific, Atricure, Acutus Medical, and Daiichi Sankyo. Dr Natale has been a consultant for Abbott, Biosense Webster, Biotronik, Boston Scientific, and iRhythm. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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