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Arrhythmias & electrophysiologyResearch article

Pulmonary vein isolation in early-onset atrial fibrillation (age ≤ 50 years): A multicenter comparison of pulsed-field ablation vs thermal energy sources

Heart RhythmPublished

  • multicenter comparison
  • consecutive patients
  • 2 tertiary centers
  • followed for 1 year
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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

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

OutcomePFACryoRFA
Major complications1.1%1.3%
phrenic nerve palsyNot reported in the abstract1 (1.1%)Not reported in the abstract
tamponadeNot reported in the abstractNot reported in the abstract2 (1.3%)
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:10.1016/j.hrthm.2026.03.1913
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Summarised from the published abstract; every number is checked against it