| Autor: |
Kupusovic, Jana, Kessler, Lukas, Bruns, Florian, Bohnen, Jan-Eric, Nekolla, Stephan G., Weber, Manuel M., Lauenroth, Anna, Rattka, Manuel, Hermann, Ken, Dobrev, Dobromir, Rassaf, Tienush, Wakili, Reza, Rischpler, Christoph, Siebermair, Johannes |
| Zdroj: |
Journal of Nuclear Cardiology; Oct2023, Vol. 30 Issue 5, p2018-2028, 11p |
| Abstrakt: |
Background: Pulsed-field ablation (PFA) is a novel ablation modality for atrial fibrillation (AF) ablating myocardium by electroporation without tissue-heating. With its different mechanism of tissue ablation, it is assumed that lesion creation is divergent to thermal energy sources. 68Ga-fibroblast-activation protein inhibitor (FAPI) PET/CT targets FAP-alpha expressed by activated fibroblasts. We aimed to assess 68Ga-FAPI uptake in pulmonary veins as surrogate for ablation damage after PFA and cryoballoon ablation (CBA). Methods: 26 patients (15 PFA, 11 CBA) underwent 68Ga-FAPI-PET/CT after ablation. Standardized uptake values (SUV) and fibroblast-activation volumes of localized tracer uptake were assessed. Results: Patient characteristics were comparable between groups. In PFA, focal FAPI uptake was only observed in 3/15 (20%) patients, whereas in the CBA cohort, 10/11 (90.9%) patients showed atrial visual uptake. We observed lower values of SUVmax (2.85 ± 0.56 vs 4.71 ± 2.06, P = 0.025) and FAV (1.13 ± 0.84 cm3 vs 3.91 ± 2.74 cm3, P = 0.014) along with a trend towards lower SUVpeak and SUVmean in PFA vs CBA patients, respectively. Conclusion: Tissue response with respect to fibroblast activation seems to be less pronounced in PFA compared to established thermal ablation systems. This functional assessment might contribute to a better understanding of lesion formation in thermal and PFA ablation potentially contributing to better safety outcomes. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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