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Acute Procedural Results of Pulsed Field Cryoablation for Persistent Atrial Fibrillation: Multicenter First-in-Human PARALELL Trial
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  • Vidal Essebag,
  • Lucas Boersma,
  • Jan Petru,
  • Mark Gallagher,
  • Vivek Reddy,
  • Tom De Potter,
  • Paweł Derejko,
  • Petr Neuzil,
  • Ilya Grigorov,
  • Atul Verma
Vidal Essebag
McGill University Health Centre
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Lucas Boersma
Amsterdam UMC Location VUmc Alzheimercentrum Amsterdam
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Jan Petru
Nemocnice na Homolce
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Mark Gallagher
St George's University Hospitals NHS Foundation Trust
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Vivek Reddy
Nemocnice na Homolce
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Tom De Potter
Hartcentrum Onze-Lieve-Vrouwziekenhuis Aalst
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Paweł Derejko
Medicover Szpital
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Petr Neuzil
Nemocnice na Homolce
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Ilya Grigorov
Adagio Medical
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Atul Verma
McGill University Health Centre

Corresponding Author:[email protected]

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Abstract

Introduction: Pulsed Field Cryoablation (PFCA) is a dual-energy cardiac ablation modality consisting of short-duration ultra-low temperature cryoablation (ULTC) followed immediately by pulsed field ablation (PFA) delivered from the same catheter. It is hypothesized that PFCA may improve contact stability during PFA, while maintaining lesion depth and effectiveness of ULTC. Methods: PARALELL is a first-in-human multicenter study evaluating safety and effectiveness of a novel PFCA catheter and system in patients with persistent atrial fibrillation (PsAF) using the combination of pulmonary vein (PVI) and posterior wall (PWI) isolation. Results: 66 patients were ablated at six sites. Groin hematoma in one patient was the only serious procedure- or device-related adverse event recorded in the study. Per protocol, acute effectiveness was evaluated in 46 patients, including 31 patients with post-hoc analysis of cryogenic energy per lesion. After an average of 21.1 ± 9.3 lesions per patient the rates of PVI and PWI were 95.7% (176/184) and 97.7% (42/43), respectively. The average cryogenic energy per patient was highly predictive of acute isolation success with ROC AUC = 0.944 and 100% rates of both PVI and PWI in 24 patients in the optimal energy cohort. Grade I microbubbles and faint muscle contractions were detected in 1.1% and 0.5% of ablations, respectively. Conclusion: This initial multi-center experience suggests that PFCA can be efficiently performed for PVI and PWI using a single versatile catheter system, with high acute success and good early safety profile. The evaluation of the chronic 12-month effectiveness of PFCA is ongoing.
01 Dec 2024Submitted to Journal of Cardiovascular Electrophysiology
03 Dec 2024Submission Checks Completed
03 Dec 2024Assigned to Editor
03 Dec 2024Review(s) Completed, Editorial Evaluation Pending
03 Dec 2024Reviewer(s) Assigned