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Arrhythmias & electrophysiologyCohort study

Pulmonary vein isolation (PVI) Durability After pulsed field ablation (PFA) or radiofrequency ablation (RFA) in Persistent-AF

JACC Clin ElectrophysiolPublished

  • prospective study with mandatory remapping procedure
  • prospectively enrolled
  • mandatory remapping procedure performed after 6 months regardless of recurrence
  • RFA in phase 1, PFA in phase 2
  • 7-day Holter electrocardiograms after 3, 6, and 12 months
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Authors' conclusion

In patients with persistent AF, PFA demonstrated PVI durability comparable to RFA. Arrhythmia recurrence occurred in a substantial proportion of patients with durable PVI, suggesting a role for non-PV mechanisms.

Study context

Population
Persistent atrial fibrillation (AF) patients undergoing PVIenrolled, 51 underwent the mandated remapping procedure · RFA (phase 1) 30 · PFA (phase 2) 30
Participants
60 patients
Exposure
PVI durability and arrhythmia recurrence between pulsed field ablation (PFA) and radiofrequency ablation (RFA)
  • PFAn = 30
  • RFAn = 30
Outcome
PVI durability
Follow-up
Remapping after a median of 7.2 months

Main finding

As reported in the abstract

Adjusted odds ratio

1.20

95% CI 0.37–3.88

P = 0.77

Events by group

PFA vs RFA
adjusted OR 1.20 (95% CI 0.37–3.88); P = 0.77

Observational data: associations, not effects.

Secondary outcomes

PVI durability in the right superior PV · lowest durability

Outcomeadjusted HR (95% CI)P value
Freedom from recurrence after mandated redo procedure · 1-year follow-up0.80 (0.24–2.64)P = 0.71
Freedom from recurrence after mandated redo procedure — Freedom from recurrence
70%
  • Freedom from recurrence after mandated redo procedure: no difference between the 2 ablation technologies; comparator group not stated in the abstract

All PVs durably isolated

Patients with all PVs durably isolated
26 patients (51%)

AF recurrence prior to the remapping procedure, by PV status

Of 26 patients with durably isolated PVs, AF recurrence
9 (35%)
Of 25 patients with reconnected PVs, AF recurrence
7 (28%)

Original publication

PVI Durability After PFA or RFA in Persistent-AF. JACC Clin Electrophysiol. Published 9 June 2026. doi:10.1016/j.jacep.2026.04.027
Read the original article ↗PubMedCite RIS · BibTeX

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