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Background <p>Achieving durable mitral isthmus (MI) block remains challenging. A novel dual-energy lattice-tip catheter enables delivery of both pulsed field (PF) and radiofrequency (RF) energy, potentially improving lesion quality and clinical outcomes. This study aims to assess the feasibility, acute success, safety, and 1-year outcomes of posterior mitral line (PML) ablation using this novel catheter in a multicenter cohort.</p> Methods <p>Consecutive patients from two European centers undergoing atrial fibrillation ablation with PML using the dual-energy system (PF-only or PF/RF, at operator discretion) were prospectively enrolled. Primary outcomes were acute MI conduction block, periprocedural complications, and arrhythmia-free survival at follow-up.</p> Results <p>Among 102 patients, PML was performed with PF-only in 80.4% and PF/RF in 19.6%. Acute MI block was achieved in 92.2% (91.5% PF-only, 95.0% PF/RF, no statistically significant difference). After a median follow-up of 356 days, 74.5% of patients were free from atrial arrhythmia (65.6% in first-time ablation), and arrhythmia-free survival appeared higher with PF/RF than PF-only (85.0% vs 72.0%), but not statistically different. Two major (ventricular fibrillation and coronary vasospasm) and five minor complications were reported. Nine patients (8.8%) underwent redo procedures. Durable MI block was confirmed in two cases, while epicardial gaps accounted for 71.4% of the seven patients with reconduction. </p> Conclusion <p>PML ablation with a dual-energy lattice-tip catheter provided high acute MI block rates, an overall favorable safety profile, and encouraging 1-year outcomes. The potential impact of combined PF/RF energy and epicardial strategies on lesion durability should be evaluated in further randomized studies.</p> Graphical abstract <p>Posterior mitral isthmus ablation with the dual-energy lattice-tip catheter provided high acute block rates, an overall favorable safety profile, and encouraging 1-year outcomes.</p> <p></p>

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Dual-energy lattice-tip catheter for posterior mitral line ablation: acute efficacy and 1-year outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月13日

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  • Wael Zaher,
  • Domenico G. Della Rocca,
  • Roberto Mené,
  • Kazutaka Nakasone,
  • Giampaolo Vetta,
  • Alexandre Almorad,
  • Antonio Sorgente,
  • Andrea Sarkozy,
  • Gian-Battista Chierchia,
  • Carlo de Asmundis,
  • Nicolas Combes,
  • Jean-Paul Albenque,
  • Serge Boveda,
  • Stephane Combes

摘要

Background

Achieving durable mitral isthmus (MI) block remains challenging. A novel dual-energy lattice-tip catheter enables delivery of both pulsed field (PF) and radiofrequency (RF) energy, potentially improving lesion quality and clinical outcomes. This study aims to assess the feasibility, acute success, safety, and 1-year outcomes of posterior mitral line (PML) ablation using this novel catheter in a multicenter cohort.

Methods

Consecutive patients from two European centers undergoing atrial fibrillation ablation with PML using the dual-energy system (PF-only or PF/RF, at operator discretion) were prospectively enrolled. Primary outcomes were acute MI conduction block, periprocedural complications, and arrhythmia-free survival at follow-up.

Results

Among 102 patients, PML was performed with PF-only in 80.4% and PF/RF in 19.6%. Acute MI block was achieved in 92.2% (91.5% PF-only, 95.0% PF/RF, no statistically significant difference). After a median follow-up of 356 days, 74.5% of patients were free from atrial arrhythmia (65.6% in first-time ablation), and arrhythmia-free survival appeared higher with PF/RF than PF-only (85.0% vs 72.0%), but not statistically different. Two major (ventricular fibrillation and coronary vasospasm) and five minor complications were reported. Nine patients (8.8%) underwent redo procedures. Durable MI block was confirmed in two cases, while epicardial gaps accounted for 71.4% of the seven patients with reconduction.

Conclusion

PML ablation with a dual-energy lattice-tip catheter provided high acute MI block rates, an overall favorable safety profile, and encouraging 1-year outcomes. The potential impact of combined PF/RF energy and epicardial strategies on lesion durability should be evaluated in further randomized studies.

Graphical abstract

Posterior mitral isthmus ablation with the dual-energy lattice-tip catheter provided high acute block rates, an overall favorable safety profile, and encouraging 1-year outcomes.