Arrhythmias & electrophysiology
Impact of pulsed field ablation-based pulmonary vein isolation on atrial fibrillation triggers originating from the superior vena cava
Authors' conclusion
These findings suggest an association between PFA and changes in conduction properties at the RA-SVC region, which may influence the distribution of SVC-related AF triggers.
Study context
- Population
- Patients undergoing first-time PV isolation (PVI) for atrial fibrillation (AF)consecutive patients undergoing first-time PVI, mechanistic sub-study n = 40 · pulsed field ablation (PFA) 146 · thermal ablation 212 · mechanistic sub-study (high-density mapping before and after PFA) 40
- Participants
- 358 patients
- Exposure
- Arrhythmia inducibility and trigger distribution were compared between PFA and thermal ablation
- PFAn = 146
- thermal ablationn = 212
Methodological detailsconsecutive patients, mechanistic sub-study with high-density mapping
- Consecutive patients
- Mechanistic sub-study with high-density mapping
Main finding
As reported in the abstract
Non-PV AF triggers induced after PVI · after PVI
Observational data: associations, not effects.
Further findings
AF triggers originating from the SVC · after PVI · significantly less frequent after PFA
P = 0.03
Conduction delay or block within the right atrium-SVC (RA-SVC) region (mechanistic sub-study, high-density mapping) · before and after PFA
- Conduction delay or block within the RA-SVC region
- 33 of 40 patients (83%)
- Electrical isolation of the superior vena cava (SVC) in patients without intentional SVC ablation
- 2 patients
Original publication
Impact of pulsed field ablation-based pulmonary vein isolation on atrial fibrillation triggers originating from the superior vena cava. Heart Rhythm. Published 24 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it