Arrhythmias & electrophysiology
Timing and characteristics of carotid microembolic signals during pentaspline pulsed field ablation
Authors' conclusion
This study demonstrated the characteristic timing, frequency, and morphology of MESs during pentaspline PFA procedures, providing insights that may help reduce embolic risks in future practice.
Study context
- Population
- Patients undergoing ablation procedures: pulmonary vein (PV) isolation with the pentaspline pulsed field ablation (PFA) system, or radiofrequency ablation limited to the right atrium (control)patients in whom MESs were assessed during ablation procedures
- Participants
- 32 patients
- Comparison
- PFA group vs control group; basket-configuration vs flower configuration energy delivery
- PFA groupn = 27
- Control groupn = 5
- Outcome
- Number of MESs
Main finding
As reported in the abstract
- The PFA group showed significantly more MESs than the control group
Further findings
Timing of MESs
- MESs were detected throughout the PFA procedure, with the highest counts observed during PFA delivery to the right PVs
Characteristics of MESs
- Bubble signals were seen in all procedural steps
- High-intensity transient signals, which are mainly composed of solid components, were more common during PFA energy delivery
Overcurrent errors
- Overcurrent errors, all during basket-type PFA applications, associated with a marked increase in MESs
- 303
MESs by energy delivery configuration
- Basket-configuration energy delivery resulted in a significantly higher number of MESs than the flower configuration, particularly in the right PVs
Size of MESs
- The size of MESs was significantly larger during PFA energy delivery than during catheter or sheath manipulation
Original publication
Timing and characteristics of carotid microembolic signals during pentaspline pulsed field ablation. Heart Rhythm. Published 30 January 2026. doi:10.
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