Arrhythmias & electrophysiologyCohort study
Atrial Fibrillation Cycle Length Dynamics During Pulmonary Vein Isolation and Posterior Wall Pulsed Field Ablation
- multicenter observational study
- consecutive patients
Authors' conclusion
Post-PVI fast LAPW activity does not predict recurrence after LAPWA in PersAF patients. CS-CL prolongation >23.5% after LAPWA may serve as a useful real-time marker of effective substrate modification and arrhythmia control.
Study context
- Population
- Consecutive persistent atrial fibrillation (PersAF) patients undergoing first-time pulmonary vein isolation (PVI) plus-LAPWA with a pentaspline pulsed field ablation (PFA) catheterpatients included
- Participants
- 270 patients
- Exposure
- Post-PVI LAPW-CL and PFA-induced atrial fibrillation cycle length (AF-CL) (CS-CL) prolongation as predictors of arrhythmia recurrence after PVI plus left atrial posterior wall ablation (LAPWA)
Main finding
As reported in the abstract
12-month ATA-free survival · 12 months
Overall 12-month atrial tachyarrhythmia (ATA)-free survival
72.6%
Observational data: associations, not effects.
Further findings
Arrhythmia recurrence by fast LAPW activity
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Fast LAPW activity · not associated with arrhythmia recurrence | 1.263 (0.739–2.160) | P = 0.393 | |
| 0.512Hazard ratio (log scale) |
Arrhythmia recurrence by CS-CL prolongation
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| greater CS-CL prolongation · independently associated | 0.298 (0.017–0.520) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
- Arrhythmia recurrence by CS-CL prolongation: independently associated with lower arrhythmia recurrence risk
CS-CL increase >23.5% from baseline for predicting ATA-free survival
- sensitivity
- 0.65
- specificity
- 0.72
Original publication
Atrial Fibrillation Cycle Length Dynamics During Pulmonary Vein Isolation and Posterior Wall Pulsed Field Ablation. Heart Rhythm. Published 24 September 2026. doi:10.1016/j.hrthm.2026.09.036
Summarised from the published abstract; every number is checked against it