Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation
Objective Pulsed-field ablation (PFA) is a new technology of catheter ablation for atrial fibrillation (AF). This research is to investigate the feasibility of a new strategy (transoesophageal echocardiography-guided pulsed field ablation, TEEP) to guide PFA for AF with no contrast and zero fluorosc...
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BMJ Publishing Group
2025-04-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003172.full |
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| author | Chao Li Jun Liu Yong Jiang Yan Yao Xiang-Bin Pan Min Tang Guodong Niu Daoliang Zhang |
| author_facet | Chao Li Jun Liu Yong Jiang Yan Yao Xiang-Bin Pan Min Tang Guodong Niu Daoliang Zhang |
| author_sort | Chao Li |
| collection | DOAJ |
| description | Objective Pulsed-field ablation (PFA) is a new technology of catheter ablation for atrial fibrillation (AF). This research is to investigate the feasibility of a new strategy (transoesophageal echocardiography-guided pulsed field ablation, TEEP) to guide PFA for AF with no contrast and zero fluoroscopy.Methods Patients with AF underwent TEEP under general anaesthesia with the guidance of three-dimensional (3D) transoesophageal echocardiography (TEE) throughout the procedure. After a successful transseptal puncture, the PFA catheter (CardiPulse) was delivered to the different pulmonary veins sequentially for standard PFA, and the pulmonary vein electrical isolation (PVI) was observed in real-time. After the ablation, left atrial bipolar voltage mapping under sinus rhythm was performed to verify the PVI.Results 10 patients with AF were enrolled, including 6 patients with paroxysmal AF and 4 patients with persistent AF. The mean operative time was 99±14 min, the mean time of the left atrial manoeuvre was 66±23 min, and the mean PFA ablation time was 105±8 s. First-pass PVI of all veins was achieved in all patients, thus no additional PFA applications were needed after the initial set. No contrast was needed and no X-ray was exposed. No complications were observed.Conclusions We report the preliminary application of 3D TEE-guided PFA for AF in the world. Its immediate safety and efficacy are promising. Compared with traditional PFA procedures, TEEP has many advantages, including accuracy of the transeptal puncture, direct visualisation of contact between the catheter and myocardial tissue, no contrast and zero fluoroscopy. |
| format | Article |
| id | doaj-art-d68340cbd6664ebd84ad0b7ef44d06ab |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-d68340cbd6664ebd84ad0b7ef44d06ab2025-08-20T02:25:36ZengBMJ Publishing GroupOpen Heart2053-36242025-04-0112110.1136/openhrt-2025-003172Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillationChao Li0Jun Liu1Yong Jiang2Yan Yao3Xiang-Bin Pan4Min Tang5Guodong Niu6Daoliang Zhang7Fuwai Shenzhen Hospital,Chinese Academy of Medical Sciences, Shenzhen, People`s Republic of ChinaFuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, ChinaFuwai Shenzhen Hospital,Chinese Academy of Medical Sciences, Shenzhen, People`s Republic of ChinaFuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, ChinaFuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, ChinaFuwai Hospital State Key Laboratory of Cardiovascular Disease, Beijing, ChinaFuwai Yunnan Cardiovascular Hospital, Kunming, Yunnan, ChinaFuwai Shenzhen Hospital,Chinese Academy of Medical Sciences, Shenzhen, People`s Republic of ChinaObjective Pulsed-field ablation (PFA) is a new technology of catheter ablation for atrial fibrillation (AF). This research is to investigate the feasibility of a new strategy (transoesophageal echocardiography-guided pulsed field ablation, TEEP) to guide PFA for AF with no contrast and zero fluoroscopy.Methods Patients with AF underwent TEEP under general anaesthesia with the guidance of three-dimensional (3D) transoesophageal echocardiography (TEE) throughout the procedure. After a successful transseptal puncture, the PFA catheter (CardiPulse) was delivered to the different pulmonary veins sequentially for standard PFA, and the pulmonary vein electrical isolation (PVI) was observed in real-time. After the ablation, left atrial bipolar voltage mapping under sinus rhythm was performed to verify the PVI.Results 10 patients with AF were enrolled, including 6 patients with paroxysmal AF and 4 patients with persistent AF. The mean operative time was 99±14 min, the mean time of the left atrial manoeuvre was 66±23 min, and the mean PFA ablation time was 105±8 s. First-pass PVI of all veins was achieved in all patients, thus no additional PFA applications were needed after the initial set. No contrast was needed and no X-ray was exposed. No complications were observed.Conclusions We report the preliminary application of 3D TEE-guided PFA for AF in the world. Its immediate safety and efficacy are promising. Compared with traditional PFA procedures, TEEP has many advantages, including accuracy of the transeptal puncture, direct visualisation of contact between the catheter and myocardial tissue, no contrast and zero fluoroscopy.https://openheart.bmj.com/content/12/1/e003172.full |
| spellingShingle | Chao Li Jun Liu Yong Jiang Yan Yao Xiang-Bin Pan Min Tang Guodong Niu Daoliang Zhang Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation Open Heart |
| title | Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation |
| title_full | Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation |
| title_fullStr | Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation |
| title_full_unstemmed | Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation |
| title_short | Initial experience of transoesophageal echocardiography-guided percutaneous pulsed field ablation of atrial fibrillation |
| title_sort | initial experience of transoesophageal echocardiography guided percutaneous pulsed field ablation of atrial fibrillation |
| url | https://openheart.bmj.com/content/12/1/e003172.full |
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