ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2021
Pulsed field ablation prevents chronic atrial fibrotic changes and restrictive mechanics after catheter ablation for atrial fibrillation.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07021313 (Deliver mOre aPplications for More Durable Pulmonary Vein IsOlation), which is not on this map. Cited by 78 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Deliver mOre aPplications for More Durable Pulmonary Vein IsOlation
Who cites it
78 citing papers in PubMed, 4 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Pulsed field ablation for the interventional treatment of atrial fibrillation: a scientific statement of the European Heart Rhythm Association of the European Society of Cardiology, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society, and the Canadian Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Guideline
- Safety and Efficacy of Pulse Field Ablation in the Treatment of Atrial Fibrillation and Its Comparison with Traditional Thermal Ablation: A Systematic Review and Meta-Analysis.Reviews in cardiovascular medicine · 2024Pooled it
- Pulsed field ablation versus thermal energy ablation for atrial fibrillation: a systematic review and meta-analysis of procedural efficiency, safety, and efficacy.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Pooled it
- Pulmonary vein isolation plus adjunctive therapy for the treatment of atrial fibrillation: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Pooled it
- Pulsed field ablation versus conventional thermal ablation for paroxysmal atrial fibrillation: 4-year outcomes in the ADVENT-LTO study.Nature medicine · 2026Trial
- Pulmonary vein narrowing after pulsed field versus thermal ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Trial
- Treatment of paroxysmal and persistent atrial fibrillation with pulsed field ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Review
- Efficacy and safety of concomitant left atrial appendage closure and pulmonary vein isolation compared to left atrial appendage closure only - A meta-analysis.International journal of cardiology. Heart & vasculature · 2026Article
- Head-to-head comparison of pulsed-field ablation, high-power short-duration ablation, cryoballoon and conventional radiofrequency ablation by MRI-based ablation lesion assessment.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Comparative analysis of hemolysis incidence across 3 different pulsed field ablation systems.Heart rhythm O2 · 2026Article
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- Pulsed-field ablation versus thermal ablation in the management of atrial fibrillation: A narrative review.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Focal Pulsed Field Ablation and Strategic Upsizing in Concomitant Atrial Fibrillation Ablation and Left Atrial Appendage Occlusion.JACC. Case reports · 2026Article
- Ablation lesion patterns in atrial fibrillation: A cardiac MRI comparison of different ablation strategies.Heart rhythm O2 · 2026Article
- Baseline remodeling-dependent changes in left atrial strain after catheter ablation for paroxysmal atrial fibrillation.Journal of echocardiography · 2026Article
- Suspected Cardioembolic Stroke Linked to Left Atrial Stunning After Pulsed Field Ablation for Atrial Fibrillation.Journal of arrhythmia · 2026Article
- Pulsed Field Ablation for Atrial Fibrillation in Japan: Current Status and Future Perspectives.Circulation reports · 2026Review
- Pulsed field ablation for idiopathic premature ventricular complexes: evaluation of acute and chronic lesion characteristics with cardiac magnetic resonance imaging.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Pulsed Field Versus Radiofrequency Ablation in Concomitant Pulmonary Vein Isolation and LAA Occlusion: Impact on Peridevice Leak and Procedural Efficiency.Journal of cardiovascular electrophysiology · 2026Article
- Pulsed Field Ablation for Atrial Fibrillation: Contemporary Clinical Evidence and Real-World Experience in Redo Ablation.Journal of clinical medicine · 2026Review
18 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 3 institutions in 2 countries.
Funding
Abstract
aimsPulsed field ablation (PFA), a non-thermal ablative modality, may show different effects on the myocardial tissue compared to thermal ablation. Thus, this study aimed to compare the left atrial (LA) structural and mechanical characteristics after PFA vs. thermal ablation. METHODS AND
resultsCardiac magnetic resonance was performed pre-ablation, acutely (<3 h), and 3 months post-ablation in 41 patients with paroxysmal atrial fibrillation (AF) undergoing pulmonary vein (PV) isolation with PFA (n = 18) or thermal ablation (n = 23, 16 radiofrequency ablations, 7 cryoablations). Late gadolinium enhancement (LGE), T2-weighted, and cine images were analysed. In the acute stage, LGE volume was 60% larger after PFA vs. thermal ablation (P < 0.001), and oedema on T2 imaging was 20% smaller (P = 0.002). Tissue changes were more homogeneous after PFA than after thermal ablation, with no sign of microvascular damage or intramural haemorrhage. In the chronic stage, the majority of acute LGE had disappeared after PFA, whereas most LGE persisted after thermal ablation. The maximum strain on PV antra, the LA expansion index, and LA active emptying fraction declined acutely after both PFA and thermal ablation but recovered at the chronic stage only with PFA.
conclusionPulsed field ablation induces large acute LGE without microvascular damage or intramural haemorrhage. Most LGE lesions disappear in the chronic stage, suggesting a specific reparative process involving less chronic fibrosis. This process may contribute to a preserved tissue compliance and LA reservoir and booster pump functions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.