Arrhythmias & electrophysiology
Pulmonary vein isolation durability in a randomized trial comparing fluoroscopy-only vs. electroanatomic mapping strategies for pulmonary vein isolation with balloon-in-basket pulsed-field ablation
Authors' conclusion
A standardized balloon-in-basket PFA workflow for PVI achieved high PVI durability. EAM guidance did not confer additional procedural or durability benefit over fluoroscopy-only guidance.
Study context
- Population
- Consecutive patients with paroxysmal or persistent atrial fibrillation (AF) undergoing de novo pulmonary vein isolation (PVI) with a balloon-in-basket pulsed field ablation (PFA) catheter86 remapped
- Participants
- 96 patients
- Comparison
- Fluoroscopy-only vs Fluoroscopy plus electroanatomic mapping (EAM)
- Primary endpoint
- Dual: proportion of PVs and of patients with all PVs durably isolated at invasive remapping
- Follow-up
- >30 days after index procedure
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Primary result
As reported in the abstract
PVI durability (all patients) · median 41 days
Per-vein durability
341/350
97.4%
Per-patient durability
79/86
91.9%
Secondary outcomes
Procedural characteristics (all patients)
- Fluoroscopy time, minutes
- 3.4 [2.4-4.6]
- Number of applications
- 15 [13-16]
- Chronic remapping parameters comparable between guidance strategies
Safety
Major adverse events within 30 days of index or remapping procedures
- No major adverse events occurred
Original publication
Pulmonary vein isolation durability in a randomized trial comparing fluoroscopy-only vs. electroanatomic mapping strategies for pulmonary vein isolation with balloon-in-basket pulsed-field ablation. Europace. Published 3 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it