Arrhythmias & electrophysiologyCohort study
Optimized workflow for pentaspline PFA and its impact on pulmonary vein isolation (PVI) durability: evidence from systematic remapping
- Prospective cohort study
- single-centre
- systematic invasive remapping
Authors' conclusion
Progressive workflow refinements for pentaspline P-PFA markedly improved PVI durability to nearly 100%, supporting the concept that PV reconnection is predominantly technique-dependent rather than intrinsic to catheter or waveform design.
Study context
- Population
- Consecutive patients undergoing first-time pentaspline PFA PVI, remapped ≥30 days after index procedure94 remapped
- Participants
- 118 patients
- Exposure
- Progressively refined pentaspline pulsed-field ablation (P-PFA) workflow: Phase 1 vs Phase 2 vs Phase 3
- Phase 1n = 30reference
- Phase 2n = 34
- Phase 3n = 30
- Outcome
- PVI durability, per vein and per patient
- Follow-up
- ≥30 days after index procedure
Main finding
As reported in the abstract
PVI durability
Per-vein durability
P = 0.005
Per-patient durability
P = 0.004
| Outcome | Phase 1 | Phase 2 | Phase 3 | P value |
|---|---|---|---|---|
| Reconnected PVs | 13 | 10 | 1 |
Observational data: associations, not effects.
Further findings
Procedure time
Mean
| Outcome | Phase 1 | Phase 2 | Phase 3 |
|---|---|---|---|
| Total PFA applications | 36.8 (SD 5.2) | 52.1 (SD 8.0) | 58.7 (SD 15.1) |
- Total PFA applications: across phases P < 0.001
- Procedure time: across phases P < 0.001
LA dwell time
- Significant parallel increase across phases
- P < 0.001
Safety
Major or minor complications (index or remapping procedures)
- No major or minor complications occurred
Original publication
Optimized workflow for pentaspline PFA and its impact on PVI durability: evidence from systematic remapping. Europace. Published 13 May 2026. doi:10.1093/europace/euag118
Summarised from the published abstract; every number is checked against it