Arrhythmias & electrophysiologyCohort study

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 RhythmPublished

  • retrospective analysis
  • multicenter
  • 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 (composite of unplanned rehospitalization for atrial arrhythmias, cardioversion, and/or repeat ablation)
Follow-up
Median 426 days

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 = 0.016
after propensity score matching
hazard ratio 0.57(0.34–0.96)
P = 0.03

Observational 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:10.1016/j.hrthm.2026.05.053

Summarised from the published abstract; every number is checked against it