Arrhythmias & electrophysiology

Acute durability of cavotricuspid isthmus block after pulsed electric field ablation: randomized comparison of two pentaspline catheter configurations (SECTION trial)

EuropacePublished Randomised controlled trial

Primary result · Acute reconductionResult — go to the resultHazard ratio 0.14 95% CI 0.06–0.40

Authors' conclusion

Pulsed electric field ablation of the CTI using the flower configuration of the pentaspline catheter demonstrated higher acute efficacy in achieving CTI block and a more favourable safety profile regarding haemolysis compared to the basket configuration.

Study context

Population
Patients undergoing pulsed electric field (PEF) ablation of the cavotricuspid isthmus (CTI) in conjunction with AF ablation
Participants
178 patients
Comparison
Flower vs basket configuration of the pentaspline catheter for PEF ablation of the CTI
  • Flowern = 83
  • Basketn = 95reference
Primary endpoint
Acute efficacy of CTI ablation (acute CTI block durability) and extent of haemolysis

Primary result

Acute reconduction

Hazard ratio

0.14

95% CI 0.06–0.40

P < 0.001

By group

Flowervs Basket
HR 0.14 (95% CI 0.06–0.40); P < 0.001

As reported in the abstract

Further findings

Time to CTI block

P < 0.001

OutcomeFlowerBasketP value
Applications required to achieve CTI block3.4 ± 3.18.0 ± 4.1P < 0.001
Total applications10.1 ± 3.413.3 ± 5.1P < 0.001

Safety

Haemolysis: post-procedural free haemoglobin · immediately after CTI ablation

P < 0.001

OutcomeFlowerBasket
Transient ST elevationsWithout clinical consequence1 events— not stated in the abstract

— not stated in the abstract

Original publication

Acute durability of cavotricuspid isthmus block after pulsed electric field ablation: randomized comparison of two pentaspline catheter configurations (SECTION trial). Europace. Published 23 September 2025. doi:10.1093/europace/euaf234

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