Pulmonary vein and posterior wall isolation using the circular, multielectrode catheter for treatment of atrial fibrillation: Acute and long-term outcomes from the Pulsed-Field Ablation for PVI Using PulseSelect With Adjunct Posterior Wall Isolation trial

doi:10.1016/j.hrthm.2026.06.002

Arrhythmias & electrophysiology

Pulmonary vein and posterior wall isolation using the circular, multielectrode catheter for treatment of atrial fibrillation: Acute and long-term outcomes from the Pulsed-Field Ablation for pulmonary vein isolation (PVI) Using PulseSelect With Adjunct Posterior Wall Isolation trial

Heart RhythmPublished 6 Jun 2026retrospectively analyzed the outcomes of consecutive patients

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Authors' conclusion

These real-world results demonstrate that PVI with/without PWI using the circular, multielectrode array PFA catheter is safe, feasible, and effective in patients with symptomatic PAF and PsAF with a low risk of complications, including hemolysis.

Study context

Population: Patients with symptomatic paroxysmal AF (PAF)/persistent AF (PsAF) who underwent catheter ablation using the circular, multielectrode pulsed-field ablation (PFA) catheterage 69 ± 11 years, 62% male, 61% PAF
Participants: 178 patients

Comparison: PVI vs PVI + posterior wall isolation (PWI)
PVI + PWIn = 172

Methodological detailsreal-world

Real-world

Main finding

As reported in the abstract

Acute PVI

Acute PVI achieved

100%

n = 178

Further findings

Freedom from recurrent atrial arrhythmia · 1 year

PAF81.6%

PsAF66.6%

Procedural characteristics

PFA applications: 62 ± 17
Procedure time: 66 ± 11 minutes
Fluoroscopy time: 14 ± 5 minutes
Patients who received PVI + PWI: 96.6% (n = 172)

Safety

Adverse events

Adverse events: 4 (2.2%)
Minor adverse events: 2

Serum total bilirubin increase · 2 hours after ablation

Increase in serum total bilirubin: 1.01 mg/dL; 95% confidence interval, 0.84-1.17; P < .001

All changes in biomarkers resolved spontaneously within 48-72 hours without clinical sequelae

Stage 1 acute kidney injury

Stage 1 acute kidney injury in patient with a history of chronic kidney disease: 1 patient

Original publication

Pulmonary vein and posterior wall isolation using the circular, multielectrode catheter for treatment of atrial fibrillation: Acute and long-term outcomes from the Pulsed-Field Ablation for PVI Using PulseSelect With Adjunct Posterior Wall Isolation trial. Heart Rhythm. Published 6 June 2026. doi:10.1016/j.hrthm.2026.06.002

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it