Arrhythmias & electrophysiology
Ablation in persistent atrial fibrillation: High long-term success with pulsed field ablation using a strict protocol
Authors' conclusion
A high long-term success rate of ablation is achievable in PersAF with PFA and tissue-contact confirmation using ICE.
Study context
- Population
- Patients with persistent AF undergoing first ablation with PFA (pulmonary vein isolation (PVI) plus posterior wall isolation (PWI), FARAPULSE system, strict protocol with intracardiac echocardiography (ICE) tissue-contact visualization and high-output pacing confirmation)
- Participants
- 109 consecutive patients
- Outcome
- Freedom from recurrent atrial arrhythmias
- Follow-up
- 12 months
Methodological detailsconsecutive patients, single-arm, Mean follow-up 15.8 ± 5.5 months
- Consecutive patients
- Single-arm
- Mean follow-up 15.8 ± 5.5 months
Main finding
As reported in the abstract
Freedom from recurrent atrial arrhythmias
79 patients
72%
Observational data: associations, not effects.
Further findings
Acute procedural success
- Procedure time
- 84 ± 12 minutes
- Dwell time
- 48 ± 10 minutes
- Mean PFA applications
- 58 ± 3.8
- Fluoroscopy time
- 14 ± 8 minutes
- PVI and PWI achieved in all patients
Repeat ablation
- Opted for a second ablation
- 8
- Durable PVI (veins)
- 90%
- Persistent PWI (patients)
- 87%
Safety
Procedural complications
- PVI and PWI achieved in all patients without complications
Original publication
Ablation in persistent atrial fibrillation: High long-term success with pulsed field ablation using a strict protocol. Heart Rhythm. Published 25 August 2025. doi:10.
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