Novel Low-Voltage MultiPulse Therapy to Terminate Atrial
Fibrillation

J 2021

Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation

NG, Fu Siong; Ondřej TOMAN; Jan PETRU; Petr PEICHL; Roger A WINKLE et al.

Základní údaje

Originální název

Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation

Autoři

Vydání

JACC: Clinical Electrophysiology, New York, Elsevier, 2021, 2405-500X

Další údaje

Typ výsledku

Článek v odborném periodiku

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 6.124

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1016/j.jacep.2020.12.014

UT WoS

000757482400004

Klíčová slova anglicky

cardioversion; defibrillation; MultiPulse Therapy; atrial fibrillation

Změněno: 10. 8. 2022 12:44, Mgr. Tereza Miškechová

Anotace

V originále

OBJECTIVES This first-in-human feasibility study was undertaken to translate the novel low-voltage MultiPulse Therapy (MPT) (Cardialen, Inc., Minneapolis, Minnesota), which was previously been shown to be effective in preclinical studies in terminating atrial fibrillation (AF), into clinical use. BACKGROUND Current treatment options for AF, the most common arrhythmia in clinical practice, have limited success. Previous attempts at treating AF by using implantable devices have been limited by the painful nature of high voltage shocks.& nbsp; METHODS Forty-two patients undergoing AF ablation were recruited at 6 investigational centers worldwide. Before ablation, electrode catheters were placed in the coronary sinus, right and/or left atrium, for recording and stimulation. After the induction of AF, MPT, which consists of up to a 3-stage sequence of far-and near -field stimulation pulses varied amplitude, duration, and interpulse timing, was delivered via temporary intracardiac leads. MPT parameters delivery methods were iteratively optimized. RESULTS In the 14 patients from the efficacy phase, MPT terminated 37 of 52 (71%) of AF episodes, with the lowest median energy of 0.36 J (interquartile range [IQR]: 0.14 to 1.21 J) and voltage of 42.5 V (IQR: 25 to 75 V). Overall, 38% AF terminations occurred within 2 seconds of MPT delivery (p < 0.0001). Shorter time between AF induction and predicted success of MPT in terminating AF (p < 0.001).& nbsp; & nbsp;CONCLUSIONS MPT effectively terminated AF at voltages and energies known to be well tolerated or painless in some patients. Our results support further studies of the concept of implanted devices for early AF conversion to reduce burden, symptoms, and progression. (J Am Coll Cardiol EP 2021;7:988 & ndash;999) (c) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Citovat

NG, Fu Siong; Ondřej TOMAN; Jan PETRU; Petr PEICHL; Roger A WINKLE; Vivek Y REDDY; Petr NEUZIL; R Hardwin MEAD; Norman A QURESHI; Zachary I WHINNETT; David W BOURN; M Brent SHELTON; Josef KAUTZNER; Arjun D SHARMA; Meleze HOCINI; Michel HAISSAGUERRE; Nicholas S PETERS a Igor R EFIMOV. Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation. JACC: Clinical Electrophysiology. New York: Elsevier, 2021, roč. 7, č. 8, s. 988-999. ISSN 2405-500X. Dostupné z: https://doi.org/10.1016/j.jacep.2020.12.014.

@article{2210917,
   author = {Ng, Fu Siong and Toman, Ondřej and Petru, Jan and Peichl, Petr and Winkle, Roger A and Reddy, Vivek Y and Neuzil, Petr and Mead, R Hardwin and Qureshi, Norman A and Whinnett, Zachary I and Bourn, David W and Shelton, M Brent and Kautzner, Josef and Sharma, Arjun D and Hocini, Meleze and Haissaguerre, Michel and Peters, Nicholas S and Efimov, Igor R},
   article_location = {New York},
   article_number = {8},
   doi = {https://doi.org/10.1016/j.jacep.2020.12.014},
   keywords = {cardioversion; defibrillation; MultiPulse Therapy; atrial fibrillation},
   issn = {2405-500X},
   journal = {JACC: Clinical Electrophysiology},
   note = {Bez afiliace k MU.},
   title = {Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation},
   volume = {7},
   year = {2021}
}

TY  - JOUR
ID  - 2210917
AU  - Ng, Fu Siong - Toman, Ondřej - Petru, Jan - Peichl, Petr - Winkle, Roger A - Reddy, Vivek Y - Neuzil, Petr - Mead, R Hardwin - Qureshi, Norman A - Whinnett, Zachary I - Bourn, David W - Shelton, M Brent - Kautzner, Josef - Sharma, Arjun D - Hocini, Meleze - Haissaguerre, Michel - Peters, Nicholas S - Efimov, Igor R
PY  - 2021
TI  - Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation
JF  - JACC: Clinical Electrophysiology
VL  - 7
IS  - 8
SP  - 988-999
EP  - 988-999
PB  - Elsevier
SN  - 2405500X
N1  - Bez afiliace k MU.
KW  - cardioversion
KW  - defibrillation
KW  - MultiPulse Therapy
KW  - atrial fibrillation
N2  - OBJECTIVES This first-in-human feasibility study was undertaken to translate the novel low-voltage MultiPulse Therapy (MPT) (Cardialen, Inc., Minneapolis, Minnesota), which was previously been shown to be effective in preclinical studies in terminating atrial fibrillation (AF), into clinical use. BACKGROUND Current treatment options for AF, the most common arrhythmia in clinical practice, have limited success. Previous attempts at treating AF by using implantable devices have been limited by the painful nature of high voltage shocks.& nbsp; METHODS Forty-two patients undergoing AF ablation were recruited at 6 investigational centers worldwide. Before ablation, electrode catheters were placed in the coronary sinus, right and/or left atrium, for recording and stimulation. After the induction of AF, MPT, which consists of up to a 3-stage sequence of far-and near -field stimulation pulses varied amplitude, duration, and interpulse timing, was delivered via temporary intracardiac leads. MPT parameters delivery methods were iteratively optimized. RESULTS In the 14 patients from the efficacy phase, MPT terminated 37 of 52 (71%) of AF episodes, with the lowest median energy of 0.36 J (interquartile range [IQR]: 0.14 to 1.21 J) and voltage of 42.5 V (IQR: 25 to 75 V). Overall, 38% AF terminations occurred within 2 seconds of MPT delivery (p < 0.0001). Shorter time between AF induction and predicted success of MPT in terminating AF (p < 0.001).& nbsp; & nbsp;CONCLUSIONS MPT effectively terminated AF at voltages and energies known to be well tolerated or painless in some patients. Our results support further studies of the concept of implanted devices for early AF conversion to reduce burden, symptoms, and progression. (J Am Coll Cardiol EP 2021;7:988 & ndash;999) (c) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
ER  -

NG, Fu Siong; Ondřej TOMAN; Jan PETRU; Petr PEICHL; Roger A WINKLE; Vivek Y REDDY; Petr NEUZIL; R Hardwin MEAD; Norman A QURESHI; Zachary I WHINNETT; David W BOURN; M Brent SHELTON; Josef KAUTZNER; Arjun D SHARMA; Meleze HOCINI; Michel HAISSAGUERRE; Nicholas S PETERS a Igor R EFIMOV. Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation. \textit{JACC: Clinical Electrophysiology}. New York: Elsevier, 2021, roč.~7, č.~8, s.~988-999. ISSN~2405-500X. Dostupné z: https://doi.org/10.1016/j.jacep.2020.12.014.

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