Arrhythmias & electrophysiology
Real-time detection of microembolic signals using carotid echocardiography: A comparative study of 3 pulsed-field systems
Authors' conclusion
VARIPULSE demonstrated a significantly higher incidence of MESs than FARAPULSE. PulseSelect produced the highest number of MESs during the initial application. Multiple SCEs/SCLs were exclusively observed with VARIPULSE.
Study context
- Population
- Patients who underwent pulsed-field ablation (PFA) for atrial fibrillationpatients who underwent PFA
- Participants
- 33 patients
- Comparison
- The number of MESs observed during procedures performed on each of the 3 PFA systems
- FARAPULSEn = 11
- PulseSelectn = 11
- VARIPULSEn = 11
- Outcome
- Number of MESs during PV isolation
- Follow-up
- During PV isolation
Main finding
As reported in the abstract
FARAPULSE
61
mean · ± 45
PulseSelect
472
mean · ± 337
VARIPULSE
858
mean · ± 266
FARAPULSE vs PulseSelect: P = 0.01 · FARAPULSE vs VARIPULSE: P < 0.001
Further findings
- Across all pulmonary vein (PVs), VARIPULSE consistently generated more MESs than FARAPULSE
- VARIPULSE generated more MESs in the inferior PVs than PulseSelect
- PulseSelect showed a higher incidence of MES during PFA of the left superior PV; the MES count decreased during the subsequent 3 PVs
Safety
| Outcome | FARAPULSE | VARIPULSE |
|---|---|---|
| SCEs/SCLs on cerebral MRI · 1 day after the procedureVARIPULSE: multiple SCEs/SCLs | 1 events | 36% |
- SCEs/SCLs on cerebral MRI: FARAPULSE: 1 patient had an SCE
SCEs/SCLs on cerebral MRI · 1 day after the procedure
- No SCEs/SCLs were observed in PulseSelect
Original publication
Real-time detection of microembolic signals using carotid echocardiography: A comparative study of 3 pulsed-field systems. Heart Rhythm. Published 30 July 2025. doi:10.
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