Arrhythmias & electrophysiologyCohort study
Variable loop circular catheter pulsed field ablation in real-world practice: Low complication rates across patient and procedural characteristics in the REAL atrial fibrillation (AF) registry
- prospective, multicenter Real-world Experience of Catheter Ablation for the Treatment of Symptomatic Paroxysmal and Persistent Atrial Fibrillation (REAL AF) registry
- consecutive ablations
Authors' conclusion
In a multicenter real-world cohort that included persistent AF and more complex strategies, the VLCC indicated a favorable early safety profile with no catheter-attributed adverse events and very low procedure-attributed complications. These findings support the feasibility of efficient, outpatient-focused PFA workflows whereas ongoing accrual will enable more granular assessment of rare events.
Study context
- Population
- Consecutive ablations for atrial fibrillation performed with the variable loop circular catheter (VLCC) for pulsed field ablation (PFA)
- Participants
- 1,014 index ablation cases
Further findings
Same-day discharge
- Same-day discharge
- 86.5%
Short-term pulmonary vein isolation
- Short-term pulmonary vein isolation achieved
- 99.6%
Safety
| Outcome | Values |
|---|---|
| Procedure-attributed complications · 3 months follow-up | VLCC 0.6% |
- Procedure-attributed complications: Events categorized by investigator-assessed relationship to procedure and/or VLCC
Procedure-attributed complications · 3 months follow-up
- Complications included cardiac tamponade/pericardial effusion attributed to a concomitant left atrial appendage closure device, sinoatrial block after accessory pathway ablation, iliac artery dissection, fluid overload, blurred vision with normal magnetic resonance imaging, and transient ischemic attack
- Half of the events occurred in cases involving adjunctive radiofrequency ablation
- No strokes, coronary spasm, or deaths were reported
- Complication rates were low in all AF types and ablation strategies
Original publication
Variable loop circular catheter pulsed field ablation in real-world practice: Low complication rates across patient and procedural characteristics in the REAL AF registry. Heart Rhythm. Published 24 April 2026. doi:10.1016/j.hrthm.2026.04.022
Summarised from the published abstract; every number is checked against it