Catheter ablation using a contact force (CF)-sensing catheter may be a safe, effective treatment option for patients with persistent AFib (PsAF), according to a new study published in JACC: Clinical Electrophysiology. The findings were originally scheduled to be presented at the Heart Rhythm Society’s 2020 Heart Rhythm Scientific Sessions.
Radiofrequency (RF) catheter ablation has already been proven to be safe and effective for paroxysmal AFib, the study’s authors noted, but its value for patients with PsAF remains unclear.
“The increased AF burden resulting from PsAF is associated with an higher risk of stroke, heart failure, and mortality compared with paroxysmal AFib,” wrote lead author Moussa Mansour, MD, Massachusetts General Hospital in Boston, and colleagues. “Although approximately one-third of AFib catheter ablation procedures worldwide are currently performed for persistent or long-standing persistent AFib, there are currently limited data on outcomes of AFib ablation in patients with nonparoxysmal AFib. To date, there is no ablation catheter approved by the FDA for PsAF.”
Mansour et al. aimed to explore this issue through the PRECEPT trial, which included data from 381 study participants from 27 different facilities in the United States and Canada. All patients had confirmed symptoms of PsAF—defined as “continuous AFib sustained beyond seven days but less than one year”—and were enrolled from July 27, 2016, to Feb. 6, 2018.
Overall, 348 participants underwent catheter ablation with a porous tip CF-sensing catheter developed by Biosense Webster. The primary adverse event (PAE) rate was 3.8%, and a thorough analysis found that its primary effectiveness success rate, after 15 months, was 61.7%. The clinical success rate was 80.4%.
“The PRECEPT study established the safety of PsAF RF ablation,” the authors wrote. “Despite the higher risk factors and comorbidities inherent to the PsAF population, the low rate of PAEs in the current study is similar to that reported in paroxysmal AFib ablation studies.”
Further research is still needed, the team added, to help determine how catheter ablation treatment for PsAF impacts atrial arrythmia rates.