Second City Sessions: Meet the LBCTrialists (On-Demand)-Meet the LBCTrialists Presentation Slides

Meet the LBCTrialists Presentation Slides

Pdf Summary

The November 2, 2026, “Meet the LBCTrialists” session presented two studies in cardiac electrophysiology.

<strong>LAAC versus NOAC after atrial fibrillation ablation:</strong> A CHAMPION-AF subgroup analysis compared left atrial appendage closure (LAAC) with anticoagulant therapy in patients who had undergone AF ablation within the prior 12 months. Among 606 patients, three-year estimates for the primary efficacy outcome—cardiovascular death, stroke, or systemic embolism—were similar with LAAC and NOACs (3.0% versus 3.1%). LAAC was associated with substantially less non-procedural bleeding (7.2% versus 21.5%) and improved net clinical benefit. Bleeding was also lower with LAAC among patients without prior ablation, though the difference was less pronounced. The subgroup was not powered to establish ablation-specific effects, and results may not apply to other time intervals after ablation.

<strong>Dual-energy catheter ablation for ventricular arrhythmias:</strong> The CLEAR-VT registry reported early experience in 59 patients treated with a lattice-tip catheter using radiofrequency ablation, pulsed-field ablation, or both. Acute outcomes included elimination of abnormal electrical signals in all VT patients, non-inducibility in 78%, and complete acute PVC suppression. At six months, estimated VT-free survival was 70%; PVC burden fell from 20.4% to 3.5% in the small PVC group. Major complications occurred in 3 patients (5%), including a CRT-D system failure after pulsed-field ablation near a lead. The investigators also observed frequent valve entrapment, occasional steam pops, and limited evidence of transmural lesions in some substrates. They emphasized that safe distances from implanted devices remain unknown and that larger, multicenter studies are needed.

Keywords

atrial fibrillation ablation

left atrial appendage closure

NOAC

CHAMPION-AF

non-procedural bleeding

cardiovascular death

stroke prevention

ventricular arrhythmia ablation

pulsed-field ablation

CLEAR-VT registry