Arrhythmias & electrophysiologyCohort study
Pulsed-Field vs Thermal Ablation of Atrial Fibrillation in Patients From the Marshall Islands
- retrospective
- consecutive
- single tertiary referral center
Authors' conclusion
In this Marshallese cohort, Gen-CS occurred universally after PFA but not after thermal ablation and was frequently clinically severe. These findings suggest population-specific susceptibility and raise the hypothesis that PFA may confer higher Gen-CS risk than thermal energies.
Study context
- Population
- Marshallese patients undergoing atrial fibrillation (AF) ablation with pulsed-field ablation (PFA) or thermal ablation (cryoballoon or radiofrequency)patients underwent AF ablation · PFA 5 · thermal 7
- Participants
- 12 patients
- Exposure
- PFA vs thermal AF ablation
- PFAn = 5
- thermaln = 7
- Outcome
- Gen-CS (diffuse multivessel coronary constriction remote from ablation sites associated with ischemic electrocardiographic changes and/or hemodynamic instability)
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Baseline cardiometabolic comorbidity burden
- Substantial and similar between groups
Safety
Clinical presentation of Gen-CS in PFA cases
- PFA cases with transient intraprocedural ischemia that resolved with intravenous nitroglycerin
- Two
- Cases presenting in delayed fashion with ischemia and ventricular fibrillation or bradycardic shock requiring vasopressors, intravenous or intracoronary nitroglycerin, and mechanical circulatory support
- Three
Original publication
Pulsed-Field vs Thermal Ablation of Atrial Fibrillation in Patients From the Marshall Islands. JACC Clin Electrophysiol. Published 7 February 2026. doi:10.1016/j.jacep.2026.01.023
Summarised from the published abstract; every number is checked against it