Evidence map›Paper›PMID 38385529›Full record

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 Cardiology2024

Long-term outcomes of the pentaspline pulsed-field ablation catheter for the treatment of paroxysmal atrial fibrillation: results of the prospective, multicentre FARA-Freedom Study.

Andreas Metzner, Martin Fiala, Johan Vijgen, Alexandre Ouss, Melanie Gunawardene, Jim Hansen, Josef Kautzner, Boris Schmidt, Mattias Duytschaever, Tobias Reichlin and 7 more

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
In one paragraph

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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05072964 (The FARAPULSE FARA-Freedom Trial A Prospective Open Label Single Arm Post Market Clinical Follow-Up Trial of the FARAPULSE Pulsed Field Ablation System in Patients With Paroxysmal Atrial Fibrillation), which is not on this map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
17.3field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT05072964 nacompletednot on this map

The FARAPULSE FARA-Freedom Trial A Prospective Open Label Single Arm Post Market Clinical Follow-Up Trial of the FARAPULSE Pulsed Field Ablation System in Patients With Paroxysmal Atrial Fibrillation

TypeinterventionalSponsorBoston Scientific CorporationRan2021 to 2023Enrolled180ConditionsParoxysmal Atrial FibrillationArmsFARAPULSE Pulsed Field Ablation System
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Efficacy and safety of a novel hexaspline pulsed field ablation system in patients with paroxysmal atrial fibrillation: the PLEASE-AF study.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 · 2024
    Trial
  3. First-in-human clinical series of a novel conformable large-lattice pulsed field ablation catheter for pulmonary vein isolation.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 · 2024
    Trial
  4. Article
  5. Article
  6. Article
  7. Single-shot ablation for AF: Real-world procedural and one-year outcomes with the newly adopted PulseSelect PFA compared with cryoballoon from the 1STOP project.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  8. Article
  9. Incidence and predictors of AF recurrence during long-term follow-up of patients after PF ablation for atrial fibrillation.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 · 2026
    Article
  10. Pulsed field ablation: from technological breakthrough to structured clinical implementation-the role of the European Heart Rhythm Association.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 · 2026
    Article
  11. Workflow and sedation choice with the PFA variable-loop circular catheter in real-world AF procedures: insights from the prospective multi-centre VARIPURE clinical study.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 · 2026
    Article
  12. Article
  13. Coronary Spasm Due to Pulsed Field Ablation: A State-of-the-Art Review.Pacing and clinical electrophysiology : PACE · 2026
    Review
  14. Gastroparesis as a potential complication of pentaspline pulsed field ablation without endoscopic esophageal injury.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Dual energy for pulmonary vein isolation using focal ablation technology integrated with a three-dimensional mapping system: SmartfIRE 12-month results.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 · 2025
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 13 institutions in 7 countries.

Andreas MetznerKlinik für Kardiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, Gebäude Ost 70, 20246 Hamburg, Germany.ORCID 0000-0002-6818-6396
Martin FialaDepartment of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.
Johan VijgenDivision of Electrophysiology, Jessa Ziekenhuis, Hasselt, Belgium.ORCID 0000-0003-4928-4836
Alexandre OussDepartment of Cardiology, Catharina Ziekenhuis, Eindhoven, The Netherlands.ORCID 0000-0001-7405-822X
Melanie GunawardeneDepartment of Cardiology and Internal Intensive Care Medicine, Asklepios Klinik St Georg, Hamburg, Germany.ORCID 0000-0001-7561-7185
Jim HansenDepartment of Cardiology, Gentofte Hospital, Hellerup, Denmark.ORCID 0000-0001-6600-9006
Josef KautznerDepartment of Cardiology, Institute for Clinical and Experimental Medicine-IKEM, Prague, Czech Republic.ORCID 0000-0002-1632-6182
Boris SchmidtCardioangiologisches Centrum Bethanien, Academic Teaching Hospital of Goethe University of Frankfurt, Frankfurt, Germany.ORCID 0000-0001-5347-9906
Mattias DuytschaeverDepartment or Cardiology, AZ SINT-Jan AV, Bruges, Belgium.ORCID 0000-0001-8451-0013
Tobias ReichlinDepartment of Rhythmology and Cardiac Electrophysiology, Inselspital University Hospital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-7197-8415
Yuri BlaauwDepartment of Cardiology, University Medical Center, Groningen, The Netherlands.
Philipp SommerDepartment of Cardiology and Rhythmology, Hdz Nrw, Bad Oeynhausen, Gemany.ORCID 0000-0002-3037-8704
Annelies VanderperAF Solutions, Boston Scientific Corp, St. Paul, MN, USA.
Anitha B AchyuthaAF Solutions, Boston Scientific Corp, St. Paul, MN, USA.
Madeline JohnsonAF Solutions, Boston Scientific Corp, St. Paul, MN, USA.ORCID 0000-0001-7524-2846
Jonathan D RaybuckAF Solutions, Boston Scientific Corp, St. Paul, MN, USA.
Petr NeuzilDepartment of Cardiology, Nemocnice Na Homolce Hospital, Prague, Czech Republic.ORCID 0000-0003-4334-8165
Boston Scientific (United States) · USAsklepios Klinik St. Georg · DEAZ Sint-Jan · BEGentofte Hospital · DKGoethe University Frankfurt · DEInstitute of Clinical and Experimental Medicine · CZJessa Hospital · BENa Homolce Hospital · CZRadboud University Nijmegen · NLUniversität Hamburg · DEUniversity Hospital Brno · CZUniversity Medical Center Groningen · NLUniversity of Bern · CH

Funding

Boston Scientific
6 · The paper itself

Abstract

aimsPulmonary vein isolation (PVI) is a well-established strategy for the treatment of paroxysmal atrial fibrillation (PAF). Despite randomized controlled trials and real-world data showing the promise of pulsed-field ablation (PFA) for this treatment, long-term efficacy and safety data demonstrating single-procedure outcomes off antiarrhythmic drugs remain limited. The aim of the FARA-Freedom Study was to evaluate the long-term efficacy and safety of PFA using the pentaspline catheter for PAF. METHODS AND

resultsFARA-Freedom, a prospective, non-randomized, multicentre study, enrolled patients with PAF undergoing de novo PVI with PFA, who were followed for 12 months with weekly transtelephonic monitoring and a 72-h Holter ECG at 6 and 12 months. The primary safety endpoint was a composite of device- or procedure-related serious adverse events out to 7 days post-ablation and PV stenosis or atrioesophageal (AE) fistula out to 12 months. Treatment success is a composite of acute PVI and chronic success, which includes freedom from any documented atrial tachyarrhythmia longer than 30 s, use of antiarrhythmic drugs or cardioversion after a 3-month blanking period, or use of amiodarone or repeat ablation at any time. The study enrolled 179 PAF patients (62 ± 10 years, 39% female) at 13 centres. At the index procedure, all PVs were successfully isolated with the pentaspline PFA catheter. Procedure and left atrial dwell times, with a 20-min waiting period, were 71.9 ± 17.6 and 41.0 ± 13.3 min, respectively. Fluoroscopy time was 11.5 ± 7.4 min. Notably, monitoring compliance was high, with 88.4 and 90.3% with weekly events and 72-h Holter monitors, respectively. Freedom from the composite primary effectiveness endpoint was 66.6%, and 41 patients had atrial tachyarrhythmia recurrence, mostly recurrent atrial fibrillation (31 patients). The composite safety endpoint occurred in two patients (1.1%), one tamponade and one transient ischaemic attack. There was no coronary spasm, PV stenosis, or AE fistula. There were four cases of transient phrenic nerve palsy, but all resolved during the index procedure.

conclusionIn this prospective, non-randomized, multicentre study, PVI using a pentaspline PFA catheter was effective in treating PAF patients despite rigourous endpoint definitions and high monitoring compliance and demonstrated favourable safety. REGISTRATION: Clinical Trials.gov Identifier: NCT05072964 (sponsor: Boston Scientific Corporation).

Indexed as

Atrial FibrillationCatheter AblationFistulaPulmonary VeinsAgedAnti-Arrhythmia AgentsConstriction, PathologicFemaleHumansMaleMiddle AgedProspective StudiesRecurrenceTachycardiaTreatment OutcomeAnti-Arrhythmia AgentsAtrial fibrillationParoxysmal atrial fibrillationPentaspline PFA catheterPulsed field ablation

Identifiers

PMID38385529
PMCPMC10932745
OpenAlexW4392128106

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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.