Arrhythmias & electrophysiologyCohort study
Electrogram-guided pulsed field ablation for persistent atrial fibrillation: A prospective cohort study
- prospective cohort study
- single-center
- nonrandomized comparative cohort study
Authors' conclusion
In this single-center, nonrandomized comparative cohort study, EGM-guided PFA demonstrated preliminary efficacy and safety in PerAF ablation, suggesting promising prospects as an innovative strategy for PerAF ablation. (ClinicalTrials, NCT06729866, EGM Guided PFA for PerAF).
Study context
- Population
- Patients with persistent atrial fibrillation (PerAF) undergoing pulsed field ablation (PFA)Electrogram (EGM) group 85 · PWI group 85
- Participants
- 85 vs 85
- Exposure
- EGM-guided PFA vs anatomic pulmonary vein isolation plus PWI
- EGM groupn = 85
- PWI groupn = 85reference
- Outcome
- Freedom from AF/atrial tachycardia (AT) recurrence after a single procedure, off antiarrhythmic drugs
- Follow-up
- 12 months
Main finding
As reported in the abstract
Hazard ratio
.47
95% CI 0.25–0.87
log-rank P = .017
Events by group
Observational data: associations, not effects.
Further findings
Intraprocedural AF termination · significantly higher in EGM group
P < 0.001
| Outcome | hazard ratio (95% CI) | P value | |
|---|---|---|---|
| AF-/AT-free survival by procedural AF termination | 0.40 (0.21–0.77) | log-rank P = .007 | |
| 0.20.5125Hazard ratio (log scale) |
- Atrial fibrillation (AF)-/AF/atrial tachycardia (AT)-free survival by procedural AF termination: procedural AF termination 84.1%
- AF-/AT-free survival by procedural AF termination: non-AF termination 64.8%
Safety
| Outcome | EGM group | PWI group |
|---|---|---|
| Primary safety end point (PFA-related adverse events) | 1.2% | Not reported in the abstract |
- Primary safety end point (PFA-related adverse events) — hemolysis in 1 patient in the EGM group
- 1.2%
Primary safety end point (PFA-related adverse events)
- No other PFA-related adverse event was observed
Original publication
Electrogram-guided pulsed field ablation for persistent atrial fibrillation: A prospective cohort study. Heart Rhythm. Published 10 March 2026. doi:10.1016/j.hrthm.2026.03.1878
Summarised from the published abstract; every number is checked against it