Arrhythmias & electrophysiologyCohort study
Cerebrovascular Ischemic Lesions After Pulsed Field Ablation for Atrial Fibrillation Using Variable-Loop Ablation Catheter
- prospective, observational, cohort, single-center study
Authors' conclusion
PFA using a variable-loop circular catheter was associated with a high rate of ICLs. More than half of the lesions were in the posterior cerebrovascular territory. (Cerebral Safety After Pulsed-Field Ablation of Atrial Fibrillation; NCT06786988).
Study context
- Population
- Patients with nonparoxysmal AF undergoing pulmonary vein and left atrial posterior wall isolation by pulsed field ablation (PFA) using a variable-loop circular catheterenrolled, study initially aimed to enroll 40 patients but was terminated early because of safety concerns
- Participants
- Twenty-one patients
Main finding
As reported in the abstract
ICLs on brain MRI · 24 hours after the procedure
Patients with ischemic cerebral lesions (ICLs)
14 (66.7%)
Lesions per patient, median (IQR)
2 (IQR: 0, 3)
Cumulative lesion burden, median
10.5 mm (6.3, 19.3)
ICLs localized in the posterior territory
28; 55.8%
Observational data: associations, not effects.
Further findings
Study conduct
- Terminated early because of safety concerns
Safety
Clinical cerebrovascular events
- Transient ischemic attack
- One patient
- Major peri-procedural stroke (National Institutes of Health Stroke Scale = 6; modified Rankin scale = 3 at the day 30 clinical follow-up)
- 1 patient
Original publication
Cerebrovascular Ischemic Lesions After Pulsed Field Ablation for Atrial Fibrillation Using Variable-Loop Ablation Catheter. JACC Clin Electrophysiol. Published 22 January 2026. doi:10.1016/j.jacep.2025.12.018
Summarised from the published abstract; every number is checked against it