Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation:MANIFEST-REDO Study
| Title: | Repeat Procedures After Pulsed Field Ablation for Atrial Fibrillation:MANIFEST-REDO Study |
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| Authors: | Scherr, Daniel; Turagam, Mohit K; Maury, Philippe; Blaauw, Yuri; van der Voort, Pepijn; Neuzil, Petr; Reichlin, Tobias; Metzner, Andreas; Vijgen, Johan; Kautzner, Josef; Boveda, Serge; Anic, Ante; Hansen, Jim; Manninger, Martin; Sommer, Philipp; Anselme, Frederic; Willems, Stephan; Deneke, Thomas; Tilz, Roland; Steven, Daniel; Wakili, Reza; Jais, Pierre; Funasako, Moritoshi; Arentz, Thomas; Rollin, Anne; Mulder, Bart A; Ouss, Alexandre; Petru, Jan; Kueffer, Thomas; Lemoine, Marc D; Koopman, Pieter; Peichl, Petr; Adelino, Raquel; Jurisic, Zrinka; Ruwald, Martin; Eberl, Anna-Sophie; Sohns, Christian; Savoure, Arnaud; Nentwich, Karin; Gunawardene, Melanie; Heeger, Christian-Hendrik; Sultan, Arian; Bohnen, Jan-Eric; Kupusovic, Jana; Derval, Nicolas; Lehrmann, Heiko; Ekanem, Emmanuel; Reddy, Vivek Y |
| Source: | Scherr, D, Turagam, M K, Maury, P, Blaauw, Y, van der Voort, P, Neuzil, P, Reichlin, T, Metzner, A, Vijgen, J, Kautzner, J, Boveda, S, Anic, A, Hansen, J, Manninger, M, Sommer, P, Anselme, F, Willems, S, Deneke, T, Tilz, R, Steven, D, Wakili, R, Jais, P, Funasako, M, Arentz, T, Rollin, A, Mulder, B A, Ouss, A, Petru, J, Kueffer, T, Lemoine, M D, Koopman, P, Peichl, P, Adelino, R, Jurisic, Z, Ruwald, M, Eberl, A-S, Sohns, C, Savoure, A, Nentwich, K, Gunawardene, M, Heeger, C-H, Sultan, A, Bohnen, J-E, Kupusovic, J, Derval, N, Lehrmann, H, Ekanem, E .... |
| Publication Year: | 2025 |
| Collection: | University of Groningen research database |
| Description: | BACKGROUND: Initial clinical studies of pulsed field ablation (PFA) to treat atrial fibrillation (AF) indicated a >90% durability rate of pulmonary vein isolation (PVI). However, these studies were largely conducted in single centers and involved a limited number of operators. The electrophysiological findings and outcomes in patients undergoing repeat ablation after an initial PF ablation for AF are incompletely understood. METHODS: In the MANIFEST-REDO study, we investigated patients who underwent repeat ablation due to clinical recurrence - AF or atrial tachycardia (AT) - following first-ever PVI with a pentaspline PFA catheter (Farawave; Boston Scientific Inc). RESULTS: At 22 centers, 427 patients (age 64±11 years; 37% female) were included. Of note, the recurrent arrhythmia leading to the repeat ablation was paroxysmal AF (51%), persistent AF (30%), or AT (19%). At the repeat procedure, the PV reconnection rates were: 30% (LSPV), 28% (LIPV), 33% (RSPV) and 32% (RIPV). In 45% of patients all PVs were durably isolated at the beginning of the repeat procedure, with the previous use of any imaging or mapping modality being univariately associated with durable PVI. After a post-redo follow-up period of 284 [90-366] days, the primary effectiveness endpoint (freedom from documented AF/AT lasting ≥30s after 3-month blanking without class I/III antiarrhythmic drugs or symptoms) was achieved in 65% of patients, with significant differences between groups (PAF 65% vs. PersAF 56% vs. AT 76%; p=0.04). Persistent AF as recurrent arrhythmia after the initial PFA ablation predicted AT/AF recurrence after repeat ablation (HR 1.241 (95% CI 1.534-1.005 CI); p=0.045). The procedural complication rate was 2.8%. CONCLUSION: In repeat procedures for AF/AT performed after an index procedure with PFA for AF, PV reconnections are not uncommon. Repeat procedures can be performed safely and with an acceptable subsequent success rate. |
| Document Type: | article in journal/newspaper |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1099-5129; 1532-2092 |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/39824172; info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/11370/484447d8-fa14-4b2f-bedd-920314a2b494; info:eu-repo/semantics/altIdentifier/pissn/1099-5129; info:eu-repo/semantics/altIdentifier/eissn/1532-2092 |
| DOI: | 10.1093/europace/euaf012 |
| Availability: | https://hdl.handle.net/11370/484447d8-fa14-4b2f-bedd-920314a2b494; https://research.rug.nl/en/publications/484447d8-fa14-4b2f-bedd-920314a2b494; https://doi.org/10.1093/europace/euaf012; https://pure.rug.nl/ws/files/1433834199/euaf012.pdf |
| Rights: | info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: | edsbas.27CB2DE8 |
| Database: | BASE |