Arrhythmias & electrophysiologyResearch article
Pulsed field ablation in patients with a prior left atrial appendage closure device and concomitant leak closure
- consecutive patients with a prior left atrial appendage occlusion (LAAO) device who underwent pulsed field ablation (PFA) alone or a concomitant leak closure procedure
Authors' conclusion
Our findings suggest that PFA in patients with an implanted LAAO device is feasible. The combined approach of PFA and leak closure demonstrated high procedural efficacy.
Study context
- Population
- Patients with a prior left atrial appendage occlusion (LAAO) device undergoing pulsed field ablation (PFA) for symptomatic AFconsecutive patients included in analysis
- Participants
- 73 patients
- Comparison
- PFA alone or a concomitant leak closure procedure
- combined procedure groupn = 18
- Outcome
- Combined procedural endpoint: procedural success (successful PFA delivery) and safety (absence of device dislodgment, new peridevice leaks (PDLs), and device-related thrombus (DRT))
Main finding
As reported in the abstract
Combined procedural endpoint achieved
70 patients (95.9%)
Further findings
| Outcome | PFA alone | combined procedure group |
|---|---|---|
| New PDLs, device-related thrombus, or dislodgment · 2-month transoesophageal echocardiography follow-up | no new PDLs, device-related thrombus, or dislodgment | 11.1% |
| residual leaks | Not reported in the abstract | 2 patients (11.1%) |
PFA system used
- Farapulse
- 45 (61.6%)
- Affera
- 28 (38.4%)
Concomitant PDL closure
- Concomitant PDL closure performed
- 18 patients (24.6%)
Radiofrequency needed to isolate the LAA
- Patients with an Amulet device requiring radiofrequency
- 3
Original publication
Pulsed field ablation in patients with a prior left atrial appendage closure device and concomitant leak closure. Heart Rhythm. Published 23 June 2026. doi:10.1016/j.hrthm.2026.06.019
Summarised from the published abstract; every number is checked against it