Heart rhythm · 2025
The effect of pulmonary vein isolation on gastric motility: Pulsed field ablation vs radiofrequency.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Shouqing, Wang Rui, Cai Cheng, Cui Chang, Wang Zidun, Liu Hailei, Chen Hongwu, Ju Weizhu, Chen Minglong
Аннотация
BACKGROUND: Pulmonary vein isolation (PVI) using radiofrequency ablation (RFA) may impair gastric motility through collateral thermal injury. Pulsed field ablation (PFA), a nonthermal modality, is expected to preferentially affect the cardiomyocytes and spare gastric motility.
OBJECTIVE: This study aimed to compare the effects of PFA and RFA for PVI on gastric motility in patients with atrial fibrillation (AF).
METHODS: In this prospective matched study, patients undergoing PFA-PVI were compared with age- and sex-matched RFA-PVI parallel controls. Gastric motility, including gastric emptying and related symptoms, was assessed before and subsequently at 48 hours after the ablation. Gastric emptying was evaluated with the emptying rate of nondigestible radiopaque markers 5 hours after ingestion, and symptoms were assessed with standardized questionnaires.
RESULTS: 28 patients with paroxysmal AF were enrolled, with 14 in each group. Acute PVI was achieved without major complications in both groups. The gastric emptying rate (GER) remained unchanged after PFA (77.9% ± 32.9% vs 78.6% ± 29.0%, P = .98) but decreased after RFA (78.6% ± 24.2% vs 66.1% ± 30.2%, P < .05). The change in GER was significantly greater after RFA than PFA (12.5% ± 24.1% vs -0.7% ± 27.1%, P < .05). New-onset delayed gastric emptying occurred in 1 (7.1%) and 3 (21.4%) patients in the PFA-PVI and RFA-PVI groups, respectively. Post-procedural gastrointestinal symptom scores worsened significantly only in the RFA group.
CONCLUSION: PFA causes significantly less damage to gastric motility than RFA during PVI, which translates into an improved quality of life for patients.
OBJECTIVE: This study aimed to compare the effects of PFA and RFA for PVI on gastric motility in patients with atrial fibrillation (AF).
METHODS: In this prospective matched study, patients undergoing PFA-PVI were compared with age- and sex-matched RFA-PVI parallel controls. Gastric motility, including gastric emptying and related symptoms, was assessed before and subsequently at 48 hours after the ablation. Gastric emptying was evaluated with the emptying rate of nondigestible radiopaque markers 5 hours after ingestion, and symptoms were assessed with standardized questionnaires.
RESULTS: 28 patients with paroxysmal AF were enrolled, with 14 in each group. Acute PVI was achieved without major complications in both groups. The gastric emptying rate (GER) remained unchanged after PFA (77.9% ± 32.9% vs 78.6% ± 29.0%, P = .98) but decreased after RFA (78.6% ± 24.2% vs 66.1% ± 30.2%, P < .05). The change in GER was significantly greater after RFA than PFA (12.5% ± 24.1% vs -0.7% ± 27.1%, P < .05). New-onset delayed gastric emptying occurred in 1 (7.1%) and 3 (21.4%) patients in the PFA-PVI and RFA-PVI groups, respectively. Post-procedural gastrointestinal symptom scores worsened significantly only in the RFA group.
CONCLUSION: PFA causes significantly less damage to gastric motility than RFA during PVI, which translates into an improved quality of life for patients.