Arrhythmias & electrophysiologyResearch article
Impact of left atrial posterior wall isolation using pulsed-field ablation in patients undergoing repeat catheter ablation for atrial fibrillation
- Propensity score matching (1:1 ratio)
- 2 centers
- consecutive patients
Authors' conclusion
Redo PVI with or without adjunctive PWI is safe and effective, with comparable arrhythmia-free survival. Adjunctive PWI prolongs procedural duration without improving outcomes. Randomized trials are required to clarify its role.
Study context
- Population
- Patients undergoing redo pulmonary vein isolation (PVI) for AF with 1–2 reconnected pulmonary veins identified on preablation mappingpatients in each group
- Participants
- 122 patients
- Comparison
- redo PVI alone vs redo PVI with adjunctive posterior wall isolation (PWI)
- PVI groupn = 122
- PVI+ groupn = 122
Main finding
As reported in the abstract
Procedure duration, left atrial dwell time, and fluoroscopy time
Significantly shorter in the PVI group
all P < .001
Further findings
| Outcome | Values |
|---|---|
| Procedural success | PVI group 100% · PVI+ group 100% |
| Arrhythmia-free survival · median follow-up of 370 days | PVI group 69% · PVI+ group 72% |
- Arrhythmia-free survival: P = .517
Baseline characteristics
- Median age
- 67 years
- Female
- 30%
- Median left atrial diameter
- 41 mm [37-46]
- Persistent AF
- 46%
Safety
- Major complication: PVI group 0.8%
- Major complication: PVI+ group 0.8%
Original publication
Impact of left atrial posterior wall isolation using pulsed-field ablation in patients undergoing repeat catheter ablation for atrial fibrillation. Heart Rhythm. Published 8 January 2026. doi:10.1016/j.hrthm.2025.12.044
Summarised from the published abstract; every number is checked against it