Arrhythmias & electrophysiology
Pulsed field ablation for atrial fibrillation with a novel simplified protocol: The pulsed field ablation (PFA) dose study
Authors' conclusion
The novel simplified PFA protocol was associated with increased procedural efficiency while maintaining noninferior efficacy and safety compared with the standard PFA protocol.
Study context
- Population
- Consecutive patients undergoing first pulmonary vein isolation (PVI) by PFA with a pentaspline catheter for AF32% female
- Participants
- 245 patients
- Exposure
- Simplified PFA dosing protocol vs standard PFA protocol for PVI
- Simple PFAn = 96
- Standard PFAn = 149reference
- Outcome
- Procedural efficiency
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
| Group | Procedure duration | Left atrial dwell time | Fluoroscopy time |
|---|---|---|---|
| Simple PFA | 40 (25-55) | 22 (13-37) | 9 (7-12) |
| Standard PFA | 53 (41-67) | 37 (27-50) | 11 (9-14) |
Procedure duration
Simple PFA40 (25-55)
Standard PFA53 (41-67)
Left atrial dwell time
Simple PFA22 (13-37)
Standard PFA37 (27-50)
Fluoroscopy time
Simple PFA9 (7-12)
Standard PFA11 (9-14)
- Simple PFA vs Standard PFA: P < 0.001 — procedure duration
- Simple PFA vs Standard PFA: P < 0.001 — left atrial dwell time
- Simple PFA vs Standard PFA: P < 0.001 — fluoroscopy time
Observational data: associations, not effects.
Further findings
First-pass isolation
P > 0.999
Freedom from atrial arrhythmias · median follow-up 373 days
P = 0.767
- Freedom from atrial arrhythmias: Findings confirmed in patients with or without electroanatomic mapping
Safety
- Overall procedural complications, all in the standard PFA group
- 4
- P = .303
Original publication
Pulsed field ablation for atrial fibrillation with a novel simplified protocol: The PFA dose study. Heart Rhythm. Published 22 November 2024. doi:10.
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