Arrhythmias & electrophysiologyCohort study
Fluoroless high-density pulsed field vs radiofrequency ablation for atrial fibrillation guided by left atrial intracardiac echocardiography: The HALO protocol
- retrospective analysis
- fluoroless workflow
- guided by left atrial (LA) intracardiac echocardiography (ICE) for contact assessment
Authors' conclusion
In a standardized fluoroless high-density antral LA ICE-guided overlapping workflow, PFA achieved better short-term rhythm control in paroxysmal AF and significantly shorter procedure times. In persistent AF, outcomes were comparable with RFA. Lesion strategy and quality are critical determinants of ablation success beyond energy source selection alone.
Study context
- Population
- Patients undergoing atrial fibrillation (AF) ablation guided by left atrial intracardiac echocardiography (ICE) for contact assessmentpatients undergoing AF ablation · pulsed field ablation (PFA) 62 · radiofrequency ablation (RFA) 130
- Participants
- 192 patients
- Exposure
- PFA vs RFA
- PFAn = 62
- RFAn = 130
Main finding
As reported in the abstract
95% CI 0.09–1.15; P = 0.082
Observational data: associations, not effects.
Further findings
Arrhythmia recurrence in paroxysmal AF · significantly lower with PFA; measure not stated
(95% CI 0.01–0.83) · P = 0.011
Posterior wall isolation in persistent AF
- Posterior wall isolation in persistent AF: P < .001
Arrhythmia recurrence in persistent AF
- recurrence rates were similar
- P = 0.569
Procedure duration
- Procedure duration was significantly shorter with PFA
Redo procedures in persistent AF
- 3.5-fold higher proportion of redo procedures in the RFA group
- P = 0.001
Original publication
Summarised from the published abstract; every number is checked against it