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Arrhythmias & electrophysiologyCohort study

Timing and incidence of symptomatic early recurrence following pulmonary vein isolation with pulsed-field compared with radiofrequency ablation

Heart RhythmPublished

  • prospective
  • Propensity score matching
  • single institution
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Authors' conclusion

PFA is associated with a significantly lower risk of ERAT compared with RF ablation. The occurrence of ERAT, irrespective of energy source, predicts a substantially higher risk of LRAT.

Study context

Population
Patients undergoing first-time pulmonary vein isolation (PVI) for atrial fibrillation (AF) between 2022 and 2025patients included · radiofrequency (RF) 420 · pulsed field ablation (PFA) 542
Participants
962 patients
Exposure
PFA versus radiofrequency ablation for atrial fibrillation
  • PFAn = 542
  • RFn = 420reference

Main finding

ERAT during the blanking period

Hazard ratio

0.61

95% CI 0.42–0.88

PFA vs RF
HR 0.61 (95% CI 0.42–0.88)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeHRP value
LRAT (atrial arrhythmias at 9 months) by ERAT — early ERAT vs RF · higher risk of LRAT; regardless of ablation modality3.78P < 0.001
LRAT (atrial arrhythmias at 9 months) by ERAT — late ERAT vs RF · higher risk of LRAT; regardless of ablation modality4.10P = 0.001

Late recurrence of atrial tachyarrhythmias (LRAT) (atrial arrhythmias at 9 months) by early recurrence of atrial tachyarrhythmias (ERAT)

3-4-fold higher risk of atrial arrhythmias at 9 months

Characteristics of patients with ERAT

Patients with ERAT were more likely to be older, have persistent AF, higher CHA2DS2-VASc scores, larger atria, reduced ejection fraction, and no prior antiarrhythmic drug use

Original publication

Timing and incidence of symptomatic early recurrence following pulmonary vein isolation with pulsed-field compared with radiofrequency ablation. Heart Rhythm. Published 7 January 2026. doi:10.1016/j.hrthm.2025.12.049
Read the original article ↗PubMedCite RIS · BibTeX

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