Arrhythmias & electrophysiologyCohort study
Esophageal endoscopic findings after pulmonary vein and posterior wall isolation using pulsed field ablation: results from the Eso-PFA study
- Prospective observational study
- consecutive patients
- real-world cohort
Authors' conclusion
In this real-world cohort, PFA-guided LAPWI was safe for the esophagus, with no thermal injury observed in post-procedural endoscopy.
Study context
- Population
- AF patients undergoing pulsed field ablation (PFA)-guided left atrial posterior wall isolation (LAPWI) with post-procedural esophagogastroduodenoscopy (EGD)94% persistent AF
- Participants
- 106 patients
- Outcome
- Esophageal safety (thermal, ablation-related esophageal lesions on EGD)
- Follow-up
- The day after PFA
Main finding
As reported in the abstract
Thermal, ablation-related esophageal lesions on EGD
- No thermal, ablation-related esophageal lesions in any patient
Observational data: associations, not effects.
Further findings
Non-ablation-related incidental gastrointestinal findings
- Patients with incidental GI findings
- 70%
Atrial arrhythmia recurrence (including antiarrhythmic drugs) · median follow-up 606 days [IQR: 212-922]
- Recurrence
- 34% (36/106)
LAPWI durability
- Durable isolation
- 78% (11/14)
Procedure time
- Median total procedure time (IQR 49-111)
- 78 min
Safety
Procedural complications
- Suspected TIA
- 1
- Minor complications
- 3
Additional esophageal adverse events during follow-up · median follow-up 606 days [IQR: 212-922]
- No additional esophageal adverse events
Original publication
Esophageal endoscopic findings after pulmonary vein and posterior wall isolation using pulsed field ablation: results from the Eso-PFA study. Europace. Published 30 June 2025. doi:10.1093/europace/euaf133
Summarised from the published abstract; every number is checked against it