Arrhythmias & electrophysiology
Safety and Effectiveness of Pulsed Field Ablation for Atrial Fibrillation in Patients With Heart Failure
Authors' conclusion
PFA appears to be potentially safe and effective in AF patients with HF. Freedom from atrial arrhythmia post-PFA was higher in patients without a history of HF, with no significant difference between HF subtypes.
Study context
- Population
- Consecutive patients undergoing pulsed field ablation (PFA) for paroxysmal or persistent atrial fibrillation (AF)
- Participants
- 1,381 patients
- Comparison
- PFA outcomes in no-HF vs HF with preserved EF (HFpEF) vs HFmr/rEF
- no-HFn = 1,174reference
- HFpEFn = 87
- HFmr/rEFn = 120
- Primary endpoint
- Freedom from documented atrial arrhythmias lasting ≥30 seconds (effectiveness); major adverse events (safety)
- Follow-up
- 1 year
Methodological detailsmulticentre, patient-level registry, consecutive patients
- Multicentre
- Patient-level registry
- Consecutive patients
Primary result
As reported in the abstract
Freedom from atrial arrhythmia
no-HF vs HFpEF, HFmr/rEF: P < 0.001 · HFmr/rEF vs HFpEF: P = 0.26
Further findings
Freedom from atrial arrhythmia, paroxysmal AF (subgroup)
Freedom from atrial arrhythmia, PerAF (subgroup)
- Freedom from atrial arrhythmia, paroxysmal AF (subgroup): P = 0.09
- Freedom from atrial arrhythmia, persistent AF (PerAF) (subgroup): P = 0.14
PerAF at baseline
- Less PerAF in no-HF than heart failure (HF)
- P < 0.001
- No difference between HF subtypes
- P = >0.99
Safety
Major adverse events
Major adverse events
- Similar between groups
Original publication
Safety and Effectiveness of Pulsed Field Ablation for Atrial Fibrillation in Patients With Heart Failure. JACC Clin Electrophysiol. Published 18 May 2024. doi:10.
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