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Arrhythmias & electrophysiologyCohort study

Durability of pulmonary vein isolation: Does the pulsed field ablation system matter?

Heart RhythmPublished

  • retrospective review
  • consecutive patients
  • 2 centers
  • propensity score-matched sensitivity analysis
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Authors' conclusion

The balloon-in-basket PFA platform demonstrated significantly greater chronic PVI durability than the pentaspline system. Propensity score matching confirmed that this durability advantage was not attributable to baseline substrate differences. These platform-specific differences are clinically meaningful and warrant prospective validation.

Study context

Population
Patients undergoing repeat ablation after a de novo pulsed field ablation (PFA) procedure for atrial fibrillation, between May 2023 and September 2025de novo PFA by catheter, 17 underwent repeat procedures, propensity score-matched n = 34 pairs · pentaspline 86 · balloon-in-basket 46
Participants
86 vs 46
Exposure
chronic pulmonary vein isolation (PVI) durability and pulmonary vein (PV) reconnection patterns after index ablation with FARAPULSE (pentaspline) and Volt (balloon-in-basket) catheters
  • pentasplinen = 86
  • balloon-in-basketn = 46

Main finding

As reported in the abstract

Clinical recurrence · median follow-up of 14.3 months (interquartile range 5.9-18.9)

patients with clinical recurrence (9 in each group)

18

of whom underwent repeat procedures (balloon-in-basket n = 9; pentaspline n = 8)

17

Observational data: associations, not effects.

Further findings

PV-level reconnection

Patient-level durability

Clinical recurrence rate · numerically higher but nonsignificant

Clinical recurrence rate, propensity-matched cohort

  • PV-level reconnection: P = .003
  • Patient-level durability: P = .049
  • Clinical recurrence rate: P = .12
  • Clinical recurrence rate, propensity-matched cohort: P = 1.000
  • Clinical recurrence rate, propensity-matched cohort: propensity score-matched sensitivity analysis (n = 34 pairs)

Arrhythmia recurrence by posterior wall isolation, combined cohort

with posterior wall isolation vs without
4.3% vs 17.6%
  • P = .031

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Durability of pulmonary vein isolation: Does the pulsed field ablation system matter? Heart Rhythm. Published 16 May 2026. doi:10.1016/j.hrthm.2026.05.018
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Summarised from the published abstract; every number is checked against it