Arrhythmias & electrophysiologyCohort study
Impact of pulsed field ablation-based pulmonary vein isolation on atrial fibrillation triggers originating from the superior vena cava
- prospective observational study
- consecutive patients
- mechanistic sub-study with high-density mapping
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
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:10.1016/j.hrthm.2026.03.1910
Summarised from the published abstract; every number is checked against it