Arrhythmias & electrophysiology
Pulmonary vein isolation in early-onset atrial fibrillation (age ≤ 50 years): A multicenter comparison of pulsed-field ablation vs thermal energy sources
Authors' conclusion
In this multicenter study of young patients undergoing first-time PVI, PFA demonstrated favorable procedural efficiency, safety, and effectiveness, supporting its potential as an effective modality in patients with early-onset AF. These findings warrant further investigation in larger data sets.
Study context
- Population
- Patients 50 years or younger with early-onset atrial fibrillation (AF) undergoing first pulmonary vein isolation (PVI)median age 46 years, 64 (17%) female, 233 (63%) with paroxysmal AF · pulsed-field ablation (PFA) 119 (32%) · Cryo 95 (26%) · radiofrequency ablation (RFA) 154 (42%)
- Participants
- 368 patients
- Comparison
- PFA, Cryo, and RFA in patients 50 years or younger with early-onset AF
- PFAn = 119
- Cryon = 95
- RFAn = 154
Methodological detailsconsecutive patients, 2 tertiary centers, followed for 1 year
- Consecutive patients
- 2 tertiary centers
- Followed for 1 year
Main finding
As reported in the abstract
Median procedure duration
Further findings
Left atrial dwell time
Kaplan-Meier recurrence-free survival · 1 year
- Left atrial dwell time: shorter with PFA and Cryo vs RFA (P < .001)
- Kaplan-Meier recurrence-free survival: PLog-rank = .064
Successful acute PVI
- Achieved in all patients
Safety
| Outcome | PFA | Cryo | RFA | |
|---|---|---|---|---|
| Major complications | 1.1% | 1.3% | ||
| Phrenic nerve palsy | Not reported in the abstract | 1 (1.1%) | Not reported in the abstract | PFA, RFA: not reported in the abstract |
| Tamponade | Not reported in the abstract | Not reported in the abstract | 2 (1.3%) | PFA, Cryo: not reported in the abstract |
- Major complications — Overall major complications
- 3 (0.8%)
Original publication
Pulmonary vein isolation in early-onset atrial fibrillation (age ≤ 50 years): A multicenter comparison of pulsed-field ablation vs thermal energy sources. Heart Rhythm. Published 23 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it