Arrhythmias & electrophysiologyCohort study
Atrial fibrillation ablation energy source transition and adjunctive lesion set utilization after commercial release of pulse field ablation
- registry study
- multivariable logistic regression
Authors' conclusion
Over the first 15 months since the United States commercial release of PFA, there was an almost complete transition from RF, CB, and RF + CB to PFA and PFA + RF. This was associated with a decrease in procedure times and a 50% increase in procedure volumes. Baseline characteristics and acute procedural safety were similar across energy sources.
Study context
- Population
- Atrial fibrillation (AF) ablations reported to the National Cardiovascular Data Registry AFib Ablation Registry, performed between January 2024 and March 2025158 United States sites
- Exposure
- AF ablation with pulsed field ablation (PFA), radiofrequency (RF), cryoballoon (CB), and combinations of these energies
Main finding
As reported in the abstract
Energy source utilization
- PFA use increased from 0% to
- 60%
- PFA + RF use increased from 0% to
- 15%
- RF use decreased from 72% to
- 22%
- CB use decreased from 16% to
- 2%
- RF + CB use decreased from 12% to
- 1%
Observational data: associations, not effects.
Further findings
Median site monthly volume of AF ablations
- Increased by approximately
- 50%
Baseline characteristics
- Similar across energy sources
Procedural characteristics with PFA
- Shorter procedures
- Increase in left atrial roof/floor/posterior wall ablation
- Decrease in cavotricuspid isthmus ablation
Original publication
Atrial fibrillation ablation energy source transition and adjunctive lesion set utilization after commercial release of pulse field ablation. Heart Rhythm. Published 24 June 2026. doi:10.1016/j.hrthm.2026.06.023
Summarised from the published abstract; every number is checked against it