Albasiri Saleh, Arafat Amr A, Al Fagih Ahmed, Alshengeiti Lamia, Dagriri Khalid A, Alkahtani Manal N, Alanazi Hind, Al Hebaishi Yahya
Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
Heart Views. 2025 Jan-Mar;26(1):1-6. doi: 10.4103/heartviews.heartviews_132_23. Epub 2025 Jul 16.
Atrial fibrillation (AF) increases morbidity and mortality. Traditional catheter ablation techniques have limitations. Pulsed-field ablation (PFA) is a new nonthermal ablation method aiming to eliminate arrhythmogenic tissue while minimizing collateral damage. The study reported the initial experience of the prince sultan cardiac center with PFA and the learning curve.
This retrospective study included 33 patients with paroxysmal or persistent AF who underwent ablation with the PFA technique from 2022 to 2023. The study outcomes included short-term and follow-up complications and AF recurrence.
The mean age was 48.52 ± 13.97 years, and 24 patients were males (72.73%). Hypertension was the most common comorbidity encountered in 11 patients (33.33%). Thirteen patients (39.39%) were on antiarrhythmic medications, and 26 (78.79%) were on nonvitamin K-dependent oral anticoagulation. The most common indication was symptomatic paroxysmal AF ( = 28; 84.85%). The preprocedural left atrial diameter was 41.82 ± 14.78 mm, and the ejection fraction was 51.36% ±8.41%. The left atrial ablation time was 45.38 ± 17.96 min, the fluoroscopy time was 33.45 ± 15.60 min, and the procedure time was 77.55 ± 19.73 min. No complications were reported postprocedurally or at 3 or 6 months. One patient had recurrent AF; one developed atrial flutter after 9 months and underwent ablation.
Pulmonary vein isolation using PFA for paroxysmal and persistent AF might be a safe and effective procedure. Future long-term studies comparing PFA with other ablation techniques are recommended.
心房颤动（AF）会增加发病率和死亡率。传统的导管消融技术存在局限性。脉冲场消融（PFA）是一种新的非热消融方法，旨在消除致心律失常组织，同时将附带损伤降至最低。该研究报告了苏丹王子心脏中心使用PFA的初步经验及学习曲线。
这项回顾性研究纳入了2022年至2023年期间接受PFA技术消融的33例阵发性或持续性AF患者。研究结果包括短期及随访并发症和AF复发情况。
平均年龄为48.52±13.97岁，24例为男性（72.73%）。高血压是最常见的合并症，11例患者（33.33%）存在该情况。13例患者（39.39%）正在服用抗心律失常药物，26例（78.79%）正在接受非维生素K拮抗剂口服抗凝治疗。最常见的适应证是有症状的阵发性AF（n = 28；84.85%）。术前左心房直径为41.82±14.78 mm，射血分数为51.36%±8.41%。左心房消融时间为45.38±17.96分钟，透视时间为33.45±15.60分钟，手术时间为77.55±19.73分钟。术后及3个月或6个月时均未报告并发症。1例患者出现AF复发；1例在9个月后发生心房扑动并接受了消融治疗。
使用PFA进行肺静脉隔离治疗阵发性和持续性AF可能是一种安全有效的方法。建议未来进行长期研究，将PFA与其他消融技术进行比较。
