PO-04-037 A PROSPECTIVE RANDOMIZED CLINICAL COMPARISON OF CATHETER ABLATION OF ATRIAL FIBRILLATION USING THE CENTAURI PEF SYSTEM, FARAPULSE SYSTEM, AND STANDARD RADIOFREQUENCY CATHETER ABLATION
| Authors | |
|---|---|
| Year of publication | 2025 |
| Type | Article in Periodical |
| Magazine / Source | HEART RHYTHM |
| MU Faculty or unit | |
| Citation | |
| web | https://www.sciencedirect.com/science/article/abs/pii/S1547527125013931 |
| Doi | http://dx.doi.org/10.1016/j.hrthm.2025.03.1172 |
| Keywords | Arrhythmia;Electrophysiology;Ablation;Cardiac;Pulse electric field |
| Description | ackground Irreversible electroporation (pulse field ablation, PFA) is a promising alternative of the radiofrequency (RF) energy in catheter ablation of atrial fibrillation (AF). Objective The aim of this study is to present one-year results comparing efficacy and safety of catheter ablation for AF using CENTAURI PEF System (CardioFocus Inc.), FARAPULSE System (Boston Scientific), and standard RF ablation. Methods Patients referred for ablation of AF (paroxysmal and persistent) were enrolled in this study and randomly assigned to one of the three groups mentioned above. RF and CENTAURI group underwent ablation using the EnSite Precision 3D mapping system and TactiCath CF ablation catheter (Abbott) with point-to-point ablation using PFA (CENTAURI) or RF energy (RF group). FARAPULSE group underwent ablation with a specialized single-shot multipolar basket catheter under X-ray and intracardiac ultrasound Results Between May 2023 and November 2024, 265 patients underwent catheter ablation for AF (159 parox. AF, 106 pers. AF). The baseline characteristics of the groups were similar. Periprocedural results - see Table. Complications - CENTAURI and RF groups had no complications, FARAPULSE group had one stroke and one tamponade. 12-month follow up - CENTAURI, 29 pts, 72% in sinus rhythm; RF, 10 pts, 60% sinus rhythm; FARAPULSE, no follow-up visits. When analyzing both paroxysmal and persistent AF cases, Conclusion Ablation with all systems appears to be comparably effective and safe. FARAPULSE results in shortest procedure time but highest X-ray dose. CENTAURI tends to shorter procedure time and faster ipsilateral pulmonary vein isolation compared to standard RF ablation. Complications in the FARAPULSE group may be attributed to the learning curve. Long-term effectiveness is limited by the small number of patients with follow-up data. |
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