Arrhythmias & electrophysiology
Nanosecond and microsecond pulse field ablation for paroxysmal atrial fibrillation: Muscle response, procedural safety, and 6-month outcomes
Authors' conclusion
NanoPFA performed under conscious sedation provides comparable safety and similar 6-month arrhythmia outcomes to microPFA under general anesthesia, with minimal pain and muscle responses, supporting the feasibility of a conscious-sedation workflow in our center.
Study context
- Population
- Patients with symptomatic paroxysmal AF
- Participants
- 151 patients
- Comparison
- Compare the muscle response, safety, and 6-month outcomes between nanoPFA and microsecond PFA (microPFA)
- nanoPFAn = 57
- microPFAn = 94
- Outcome
- Pulmonary vein and superior vena cava isolation
Methodological detailspropensity score matching (sensitivity analysis)
- Propensity score matching (sensitivity analysis)
Main finding
As reported in the abstract
- Pulmonary vein and superior vena cava isolation was completed in all
Further findings
Kaplan-Meier freedom from any atrial tachyarrhythmia · 6 months
P = 0.57
Freedom from any atrial tachyarrhythmia after PSM · 6 months · propensity score matched (sensitivity analysis)
P = 0.56
Muscle contraction during nanoPFA
- Absent
- 43.9%
- Slight
- 47.4%
- Severe
- 8.8%
- Most frequently at the right superior pulmonary vein
Pain (VAS) and patient preference, nanoPFA
- VAS 0-4 (mild/no discomfort)
- 71.9% [41/57]
- Preferred conscious sedation
- 87.7%
- None reported severe pain
Original publication
Nanosecond and microsecond pulse field ablation for paroxysmal atrial fibrillation: Muscle response, procedural safety, and 6-month outcomes. Heart Rhythm. Published 8 May 2026. doi:10.
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