ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Pulsed field ablation in patients with cardiac implantable electronic devices: an ex vivo assessment of safety.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Empirical Superior Vena Cava Isolation Added to Pulmonary Vein Isolation in Atrial Fibrillation: A Systematic Review and Meta-Analysis.BMC cardiovascular disorders · 2026Pooled it
- Safety considerations and clinical monitoring during 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
- Successful superior vena cava isolation using point-by-point cryothermal ablation after failed radiofrequency ablation.Journal of cardiology cases · 2026Article
- Context-dependent interactions between variable-loop pulsed field ablation and cardiac implantable electronic devices: a controlled preclinical study.European heart journal open · 2026Article
- Transient reset of a ventricular leadless pacemaker after monopolar pulsed field ablation: A case report with ex vivo validation.HeartRhythm case reports · 2026Article
- Focal pulsed field ablation at the coronary sinus ostium in the presence of a left ventricular lead: A case report.HeartRhythm case reports · 2026Article
- Irreversible intracardiac defibrillator circuit damage induced by pulsed-field ablation: Mechanistic insights.HeartRhythm case reports · 2026Article
- Pulsed Field Ablation in Patients With Cardiac Implantable Electric Devices: Vigilance Is Warranted.Pacing and clinical electrophysiology : PACE · 2026Review
- Advent of Pulsed Field Ablation for Atrial Fibrillation: State-of-the-Art Review.Reviews in cardiovascular medicine · 2025Review
- A case of near-zero fluoroscopy ablation using a variable-loop circular catheter in a patient with a dual-chamber leadless pacemaker.HeartRhythm case reports · 2025Article
- Safety and feasibility of pulsed field ablation with a pentaspline catheter in patients with cardiac implantable electronic devices: a multicentre experience.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 · 2025Article
- Safety of pulsed field ablation using a variable loop circular catheter in a patient with a cardiac implantable electronic device.HeartRhythm case reports · 2025Article
- Pulsed field ablation can be a source of electromagnetic interference with cardiac implantable electronic devices.HeartRhythm case reports · 2024Article
Corrections and comments
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Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulse field ablation (PFA) is a novel catheter ablation technology with potential safety benefits due to its tissue selectivity. It has the potential to directly damage or interact with the functionality of cardiac implantable electronic devices (CIEDs) in the form of electromagnetic interference (EMI). The aim of our study was to assess the impact of PFA on CIEDs.
methodsPFA lesions (45 per CIED) were applied from the Farapulse system to CIEDs (< 5 cm from the lead tip and < 15 cm from the generator). All devices were checked before and after PFA application for proper sensing and pacing functionality as well as for integrity of shock circuits in ICDs using a heart simulator. Moreover, devices were then interrogated for any spontaneous reprogramming, mode switching or other EMI effects.
resultsIn total, 44 CIEDs were tested (16 pacemaker, 21 ICDs, 7 CRT-P/D) with 1980 PFA applications. There was no change in device settings, functionality and electrical parameters, and there was no macroscopic damage to the devices. The risk of damage to the electric components or leads on a patient-based analysis is 0/44 (95% CI 0-8%) and on a PFA pulse-based analysis is 0/1980 (95% CI 0-0.2%). Clinically relevant EMI appeared with oversensing and pacing inhibition but not tachycardia detection.
conclusionsBipolar PFA appears safe and does not result in damage to CIEDs or leads. Clinically relevant EMI does occur, but appropriate peri-procedural programming may mitigate this. In vivo studies are needed to confirm our findings.
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