Arrhythmias & electrophysiology
Insights Into Early Adoption and Physician Learning Curve of Pulsed Field Ablation in the United States
Authors' conclusion
Initial US experience with the pentaspline PFA catheter demonstrated key differences from previously reported European workflows, including higher use of general anesthesia and electroanatomic mapping. Physician learning curve analysis indicated rapid adoption, with improvements in procedural efficiency and consistent safety with operator experience.
Study context
- Population
- Patients undergoing first-time pulsed field ablation (PFA) with the pentaspline catheter for paroxysmal or nonparoxysmal AF, US
- Participants
- 1,076 patients
- Outcome
- Acute procedural efficiency and workflow
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
- Ablation beyond the pulmonary veins
- 80.9%
- General anaesthesia
- 90.2%
- Electroanatomic mapping
- 94.8%
- Procedural time, mean±SD (minutes)
- 66.64±28.36
- Fluoroscopy time, median (minutes)
- 6.17 (0-11.6)
- Zero-fluoroscopy approach
- 25.3%
- Low-fluoroscopy approach (<2 minutes)
- 31%
Observational data: associations, not effects.
Further findings
Learning curve (experience 1 to 3, 4 to 10, >11 procedures)
- Procedural and fluoroscopy times decreased with operator experience
Safety
- Overall procedure-related complication rate
- 1.7%
- Driven primarily by vascular access complications requiring intervention or transfusion
Original publication
Insights Into Early Adoption and Physician Learning Curve of Pulsed Field Ablation in the United States. Circ Arrhythm Electrophysiol. Published 24 October 2025. doi:10.
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