Arrhythmias & electrophysiologyCohort study
COnCOmitaNt pulsed field ablation-based pUlmonary vein isolation and lefT atrial appendage closure: the COCONUT study
- Retrospective registry study
- multinational
- multicentre
Authors' conclusion
In this large multicentre study, concomitant PFA-based AF ablation and LAA closure proved to be feasible, effective, and safe and overall procedure duration was short.
Study context
- Population
- Patients undergoing concomitant pentaspline catheter pulsed field ablation (PFA)-based pulmonary vein isolation (PVI) and left atrial appendage closure (LAAC), 22 centres in nine European countries
- Participants
- 155 patients · 22 centres
- Outcome
- Safety: serious adverse events; efficacy: success of PVI and LAA closure (isolation of all pulmonary veins and successful LAA closure)
Main finding
As reported in the abstract
Primary efficacy endpoint achieved
97.4%
Successful PVI
100%
Successful LAAC
151/155 (97.4%)
Primary safety endpoint (serious adverse events)
3/155 (1.9%)
Observational data: associations, not effects.
Secondary outcomes
TOE and/or CCTA imaging follow-up · 67 ± 26 days after the procedure
- Peri-device gaps <5 mm
- 24/151 (15.9%)
- Peri-device gaps >5 mm
- 3/151 (2.0%)
- No device embolization
- No device-related thrombus
Sinus rhythm at arrhythmia follow-up >6 months
- Sinus rhythm
- 78.1%
- 137/155 patients with available arrhythmia follow-up
Safety
Serious adverse events (primary safety endpoint)
- Serious adverse events
- 3/155 (1.9%)
Original publication
COnCOmitaNt pulsed field ablation-based pUlmonary vein isolation and lefT atrial appendage closure: the COCONUT study. Europace. Published 9 September 2026. doi:10.1093/europace/euag198
Summarised from the published abstract; every number is checked against it