Trial reportJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Targeted ablation of epicardial ganglionated plexi during cardiac surgery with pulsed field electroporation (NEURAL AF).
Trial report in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04775264 (Safety and Feasibility of Atrial Deganglionation as Adjunctive Therapy for Atrial Fibrillation), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Safety and Feasibility of Atrial Deganglionation as Adjunctive Therapy for Atrial Fibrillation
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Peri-procedure and Mid-Long Term Effects of Pulsed Field Ablation vs. Thermal Ablation (Cryo- or Radiofrequency) on Autonomic Nervous System Function in Atrial Fibrillation: A Systematic and Quantitative Pooled-Analysis with Potential Implications for Patient Selection (The PULSE-COLD-HEAT-ANS Collaboration).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 · 2025Pooled it
- Pulsed-field ablation versus thermal ablation for atrial fibrillation: an updated systematic review and meta -analysis of randomized controlled trials and observational studies with time-to-event analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Computational Assessment of Electrical and Thermal Effects of Epicardial Pulsed Field Ablation Adjacent to Stented Arteries.Bioengineering (Basel, Switzerland) · 2026Article
- Short-term deceleration capacity: a novel non-invasive indicator of parasympathetic activity in patients undergoing pulmonary vein isolation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025Article
- Contemporary Trends in Pulsed Field Ablation for Cardiac Arrhythmias.Journal of cardiovascular development and disease · 2024Review
- Ablation Strategies for Persistent Atrial Fibrillation: Beyond the Pulmonary Veins.Journal of clinical medicine · 2024Review
- State-of-the-art pulsed field ablation for cardiac arrhythmias: ongoing evolution and future perspective.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 · 2024Review
- Development of neuromodulation for atrial fibrillation: a narrative review.Journal of thoracic disease · 2024Review
- Pulsed Field Ablation for Atrial Fibrillation: Mechanisms, Advantages, and Limitations.Reviews in cardiovascular medicine · 2024Review
- Epicardial Pulsed Field Ablation of Ganglionated Plexi: Computational and Pre-Clinical Evaluation of a Bipolar Sub-Xiphoid Catheter for the Treatment of Atrial Fibrillation.Bioengineering (Basel, Switzerland) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundModulation of the cardiac autonomic nervous system (ANS) is a promising adjuvant therapy in the treatment of atrial fibrillation (AF). In pre-clinical models, pulsed field (PF) energy has the advantage of selectively ablating the epicardial ganglionated plexi (GP) that govern the ANS. This study aims to demonstrate the feasibility and safety of epicardial ablation of the GPs with PF during cardiac surgery with a primary efficacy outcome of prolongation of the atrial effective refractory period (AERP).
methodsIn a single-arm, prospective analysis, patients with or without a history of AF underwent epicardial GP ablation with PF during coronary artery bypass grafting (CABG). AERP was determined immediately pre- and post- GP ablation to assess cardiac ANS function. Holter monitors were performed to determine rhythm status and heart rate variability (HRV) at baseline and at 1-month post-procedure.
resultsOf 24 patients, 23 (96%) received the full ablation protocol. No device-related adverse effects were noted. GP ablation resulted in a 20.7 ± 19.9% extension in AERP (P < 0.001). Post-operative AF was observed in 7 (29%) patients. Holter monitoring demonstrated an increase in mean heart rate (74.0 ± 8.7 vs. 80.6 ± 12.3, P = 0.01). There were no significant changes in HRV. There were no study-related complications.
conclusionsThis study demonstrates the safety and feasibility of epicardial ablation of the GP using PF to modulate the ANS during cardiac surgery. Large, randomized analyses are necessary to determine whether epicardial PF ablation can offer a meaningful impact on the cardiac ANS and reduce AF.
trial registrationClinical trial registration: NCT04775264.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.