Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jan;11(1):98-106.
doi: 10.1016/j.jacep.2024.09.025. Epub 2024 Nov 20.

Safety and Feasibility of Pulsed-Field Ablation in Patients With Mechanical Prosthetic Valves

Roberto Scacciavillani  1 , Domenico G Della Rocca  2 , Devi Nair  3 , Michele Magnocavallo  4 , Andrzej Głowniak  5 , Sanghamitra Mohanty  6 , Antonio Sorgente  7 , Roberto Mené  8 , Alexandre Almorad  7 , Giampaolo Vetta  7 , Luigi Pannone  7 , Katarzyna Wojewoda  5 , Lorenzo Marcon  7 , Erwin Stroker  7 , Gezim Bala  7 , Aleksander Konopka  5 , Juan Sieira  7 , Stefano Bianchi  4 , Kirollos Gabrah  3 , Pietro Rossi  4 , Andrea Sarkozy  7 , Serge Boveda  8 , Andrea Natale  8 , Carlo de Asmundis  7 , Gian-Battista Chierchia  7
Affiliations
Multicenter Study

Safety and Feasibility of Pulsed-Field Ablation in Patients With Mechanical Prosthetic Valves

Roberto Scacciavillani et al. JACC Clin Electrophysiol. 2025 Jan.

Abstract

Background: Pulsed-field ablation (PFA) is a novel ablation energy source, which leads to selective and irreversible electroporation of cardiomyocytes with no collateral damage to adjacent tissues. The presence of mechanical prosthetic valves may pose some issues related to catheter manipulation and risk of electromagnetic interference.

Objectives: The purpose of this study was to assess the feasibility of PFA in patients with mechanical prosthetic valves.

Methods: The authors enrolled 30 consecutive patients (age 64.7 ± 11.4 years; 43% men) with mitral and/or aortic valve replacement with mechanical substitutes undergoing endocardial AF ablation via a PFA technology at 6 institutions.

Results: Time between valve surgery and ablation was 6.6 ± 6.5 years; 14 (46.7%) patients had an aortic mechanical valve, 10 (33.3%) a mitral, and 6 (20.0%) both. The following PFA technologies were used: FARAWAVE in 25 patients, Sphere-9 in 2, PulseSelect in 2, and the CENTAURI System in 1. No periprocedural and 1-month postablation major and minor complications were observed. Postprocedural transthoracic echocardiography did not identify any prosthetic valve dysfunction. One patient showed electromagnetic interference of the PFA catheter adjacent to the mitral prosthesis without clinical implications. No energy delivery to the mitral edge of the isthmus was possible despite multiple attempts to reposition the catheter. Mean procedural time was 77.5 ± 29.9 minutes, whereas mean left atrial dwell and fluoroscopy times were 43.1 ± 21.4 and 14.0 ± 6.4 minutes, respectively.

Conclusions: PFA in patients with mechanical valves appears safe, but careful catheter handling is essential to avoid electromagnetic interference hindering PFA delivery.

Keywords: ablation; atrial fibrillation; electromagnetic interference; mechanical valves; pulsed field ablation.

PubMed Disclaimer

Conflict of interest statement

Funding Support and Author Disclosures Dr Natale has received speaker honoraria from Boston Scientific, Biosense Webster, Abbott, Biotronik, and Medtronic; and is a consultant for Biosense Webster, Abbott, and Janssen. Dr de Asmundis has received research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips and Acutus. Dr Chierchia has received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific and Acutus Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Publication types

LinkOut - more resources