Arrhythmias & electrophysiology
Effects of Pulsed Field Ablation for Pulmonary Vein Isolation on Vein of Marshall Electrograms
Authors' conclusion
The impact of PFA on VoM electrograms varied among PFA systems and was largely determined by the PFA electrode-VoM distance. Notably, the majority of VoM electrogram alterations were transient.
Study context
- Population
- Patients undergoing pulsed field ablation (PFA)-based PV isolationpatients undergoing PFA-based PV isolation · FARAPULSE 28 · VARIPULSE 21 · PulseSelect 23
- Participants
- 72 patients
- Comparison
- FARAPULSE vs VARIPULSE vs PulseSelect
- FARAPULSEn = 28
- VARIPULSEn = 21
- PulseSelectn = 23
Methodological detailscontinuous vein of Marshall (VoM) electrogram recording with a 1.6-F electrode catheter
- Continuous VoM electrogram recording with a 1.6-F electrode catheter
Main finding
As reported in the abstract
VoM electrogram effect during PFA-based PV isolation
VoM electrograms eliminated
16 patients
22%
VoM electrograms reduced
16 patients
22%
Further findings
PFA electrode-VoM distance by electrogram effect (median [Q1-Q3])
- PFA electrode-VoM distance by electrogram effect (median [Q1-Q3]): P < 0.001
Extent of VoM electrogram alteration by PFA system
- Differed among PFA systems and was greatest with FARAPULSE
- P < 0.001
Recovery among patients with acute VoM electrogram elimination · by the end of the procedure
- Persistent elimination, among patients with acute VoM electrogram elimination
- 9 patients (56%)
- Partial recovery, among patients with acute VoM electrogram elimination
- 1 patient (6%)
- Complete restoration, among patients with acute VoM electrogram elimination
- 6 patients (38%)
Recovery among patients with acute VoM electrogram reduction
- All patients with acute VoM electrogram reduction showed complete recovery
Persistent VoM electrogram modification
- Overall, of patients undergoing PFA-based PV isolation
- 14%
Original publication
Effects of Pulsed Field Ablation for Pulmonary Vein Isolation on Vein of Marshall Electrograms. JACC Clin Electrophysiol. Published 22 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it