Arrhythmias & electrophysiology
Impact of adjunctive posterior left atrial ablation using pulsed field ablation on health care utilization in patients receiving first-time catheter ablation for atrial fibrillation: Results from the multicenter SENTINEL registry
Authors' conclusion
In this large multicenter comparative analysis of adjunctive PLAA+PVI vs PVI alone using PFA, adjunctive PLAA ablation was safe and was associated with lower health care utilization in patients receiving first-time catheter ablation for atrial fibrillation.
Study context
- Population
- Patients who underwent first-time ablation with Farapulse pulsed field ablation (PFA) system, Australia and New Zealand Pentaspline PFA registrypatients who underwent ablation, adjunctive posterior left atrial ablation (PLAA) performed in 30%
- Participants
- 1,611 patients
- Exposure
- Pulmonary vein isolation (PVI)+PLAA with PVI alone using PFA
- Outcome
- Health care utilization:
- Unplanned rehospitalization for atrial arrhythmias
- Cardioversion
- Repeat ablation
- Follow-up
- Median 426 days
Methodological detailsmulticenter, registry
- Multicenter
- Registry
Main finding
As reported in the abstract
PVI+PLAA vs PVI aloneEstimate (95% CI)P value
After adjustment for baseline differences
adjusted hazard ratio 0.52(0.31–0.89)
P = 0.016After propensity score matching
hazard ratio 0.57(0.34–0.96)
P = 0.03Observational data: associations, not effects.
Further findings
Non-paroxysmal atrial fibrillation (baseline)
- Non-paroxysmal atrial fibrillation (baseline): P < .01 for all comparisons
Unplanned rehospitalization, cardioversion, and clinical arrhythmia recurrence (adjusted)
- All significantly lower for PVI+PLAA
- P < 0.05
Safety
30-day adverse events
- 30-day adverse events: P = .50
Original publication
Impact of adjunctive posterior left atrial ablation using pulsed field ablation on health care utilization in patients receiving first-time catheter ablation for atrial fibrillation: Results from the multicenter SENTINEL registry. Heart Rhythm. Published 4 June 2026. doi:10.
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