Arrhythmias & electrophysiology
Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience
Authors' conclusion
In a large, multicenter experience, PFA was associated with more common use of general anesthesia, shorter procedural times, and longer fluoroscopy exposure compared with vHPSD ablation, with both techniques displaying superimposable safety and efficacy.
Study context
- Population
- Consecutive patients with paroxysmal or persistent atrial fibrillation (AF) undergoing ablation, 2020–2023
- Participants
- 534 patients
- Exposure
- Pulsed field ablation (PFA) vs very high-power short-duration (vHPSD) radiofrequency ablation
- PFAn = 192
- vHPSDn = 342reference
- Outcome
- Atrial tachyarrhythmia recurrence after a 1-month blanking period
- Follow-up
- 12 months
Methodological detailsmulticentre, propensity-score matched
- Multicentre
- Propensity-score matched
Main finding
As reported in the abstract
Survival free from recurrent atrial tachyarrhythmia
Log-rank P = .73
Observational data: associations, not effects.
Further findings
Procedure duration
P < 0.001
Fluoroscopy time
P < 0.001
| Outcome | PFA | vHPSD | P value |
|---|---|---|---|
| Freedom from recurrent atrial tachyarrhythmia, propensity score-matched patients (n = 342) · 12 monthsMatched cohort | — not stated in the abstract | 12-month estimate 77% | log-rank P = .980 |
— not stated in the abstract
General anaesthesia use
- More frequent with PFA
- P < 0.001
Pulmonary vein isolation
- Achieved in all patients
Safety
Composite of procedure-related complications (primary safety end point)
P = 0.745
- Composite of procedure-related complications (primary safety end point): 19 patients (3.5%) overall
Original publication
Pulsed field vs very high-power short-duration radiofrequency ablation for atrial fibrillation: Results of a multicenter, real-world experience. Heart Rhythm. Published 27 May 2024. doi:10.
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