Arrhythmias & electrophysiology
Anterior mitral isthmus line using pulsed-field ablation with the pentaspline catheter or radiofrequency ablation: procedural characteristics, safety, and mid-term outcomes
Authors' conclusion
Anterior MIL ablation using PFA is feasible, safe, and more time-efficient than RFA, with comparable mid-term arrhythmia outcomes.
Study context
- Population
- Patients undergoing pulmonary vein isolation (PVI) with anterior mitral isthmus line (MIL) ablation (SWISS-AF-PVI registry; median age 70 years, 40% female)
- Participants
- 129 patients
- Exposure
- Pulsed-field ablation (PFA) vs radiofrequency ablation (RFA) for anterior mitral isthmus line ablation
- PFAn = 61
- RFAn = 68reference
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Procedural characteristics
| Group | Total procedure time | LA dwell time | Ablation time |
|---|---|---|---|
| PFA | 71 min | 53 min | 27 min |
| RFA | 108 min | 80 min | 50 min |
Total procedure time
PFA71 min
RFA108 min
LA dwell time
PFA53 min
RFA80 min
Ablation time
PFA27 min
RFA50 min
- PFA vs RFA: P < 0.001 — total procedure time
- PFA vs RFA: P < 0.001 — LA dwell time
- PFA vs RFA: P < 0.001 — ablation time
Observational data: associations, not effects.
Further findings
Arrhythmia-free survival · median follow-up 327 days · similar between groups
P = 0.34
| Outcome | PFA | RFA | P value | |
|---|---|---|---|---|
| MIL ablation applications | P < 0.001 | |||
| Applications | 14 | Not reported in the abstract | RFA: not reported in the abstract | |
| Application time | 35 s | 473 s |
Incomplete MIL at redo procedure
- Incomplete MIL among 34 redo patients
- 53%
- No significant difference between groups
Safety
Major complications
- Major complications (total)
- 3
Original publication
Anterior mitral isthmus line using pulsed-field ablation with the pentaspline catheter or radiofrequency ablation: procedural characteristics, safety, and mid-term outcomes. Europace. Published 23 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it