Comparative evaluation of 2 pulsed field ablation systems for atrial fibrillation: insights from real-world clinical implementation and short-term outcomes
Background - Pulsed field ablation (PFA) is a safe and effective technology for catheter ablation of atrial fibrillation (AF). Multiple PFA-platforms for AF ablation have been developed. However, evidence comparing the real-world implementation and performance of different PFA systems is still limit...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
September 2025
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| In: |
Heart rhythm
Year: 2025, Volume: 22, Issue: 9, Pages: 2201-2208 |
| ISSN: | 1556-3871 |
| DOI: | 10.1016/j.hrthm.2024.10.068 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.hrthm.2024.10.068 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1547527124035331 
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| Author Notes: | Maura M. Zylla, MD, Christine Mages, MD, Ann-Kathrin Rahm, MD, Felix Wiedmann, MD, Patrick A. Schweizer, MD, Dierk Thomas, MD, FHRS, Norbert Frey, MD, Patrick Lugenbiel, MD |
| Summary: | Background - Pulsed field ablation (PFA) is a safe and effective technology for catheter ablation of atrial fibrillation (AF). Multiple PFA-platforms for AF ablation have been developed. However, evidence comparing the real-world implementation and performance of different PFA systems is still limited. - Objective - This study compares procedural and acute outcome parameters during implementation of the PFA system employing a pentaspline PFA catheter (FARAPULSE, Boston Scientific, Marlborough, MA) and a platform using a circular PFA-catheter (PulseSelect, Medtronic, Minneapolis, MN). - Methods - The first consecutive 40 patients treated with each PFA system were included. Baseline characteristics, procedural parameters, and short-term outcome regarding periprocedural safety and efficacy were evaluated. - Results - The majority of patients showed paroxysmal AF, nearly one-third of patients in both groups suffered from persistent AF. Overall procedural complication rates were not different among subgroups (circular catheter: 12.5%; pentaspline catheter: 7.5%, P = .71), mainly minor (circular catheter: 10.0%; pentaspline catheter: 7.5%, P =1.00). There was no significant difference in median procedure duration (circular catheter: 42.0 minutes; pentaspline catheter: 43.0 minutes, P = .292), left atrial (LA) dwell time (circular catheter: 29.0 minutes; pentaspline catheter: 31.0 minutes, P = .623), and fluoroscopy duration (circular catheter: 13.2 min; pentaspline catheter: 11.9 minutes, P = .132). With the pentaspline PFA catheter, no learning curve was observed regarding procedural parameters over the course of 40 procedures. With the circular PFA catheter, there was a statistically significant decrease in LA dwell time and fluoroscopy duration comparing the first and last 10 procedures. - Conclusion - Both PFA systems could be safely and rapidly implemented into clinical practice of an experienced center. Large-scale clinical trials are needed to compare long-term outcome between different PFA systems currently introduced into clinical practice. |
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| Item Description: | Online veröffentlicht: 7. November 2024, Artikelversion: 3. September 2025 Gesehen am 10.12.2025 |
| Physical Description: | Online Resource |
| ISSN: | 1556-3871 |
| DOI: | 10.1016/j.hrthm.2024.10.068 |