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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Hauptverfasser: Zylla, Maura Magdalena (VerfasserIn) , Mages, Christine (VerfasserIn) , Rahm, Ann-Kathrin (VerfasserIn) , Wiedmann, Felix Tobias (VerfasserIn) , Schweizer, Patrick Alexander (VerfasserIn) , Thomas, Dierk (VerfasserIn) , Frey, Norbert (VerfasserIn) , Lugenbiel, Patrick (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: September 2025
In: Heart rhythm
Year: 2025, Jahrgang: 22, Heft: 9, Pages: 2201-2208
ISSN:1556-3871
DOI:10.1016/j.hrthm.2024.10.068
Online-Zugang: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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Verfasserangaben: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

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520 |a 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. 
650 4 |a Atrial fibrillation 
650 4 |a Catheter ablation 
650 4 |a Complications 
650 4 |a Pulmonary vein isolation 
650 4 |a Pulsed field ablation 
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