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 Cardiology2025
Repeat procedures after pulsed field ablation for atrial fibrillation: MANIFEST-REDO study.
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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Pulsed field ablation for persistent atrial fibrillation: meta-analysis of pulmonary vein isolation with or without posterior wall isolation.Scientific reports · 2026Pooled it
- Efficacy and safety of pulsed field ablation and very high-power short-duration ablation for atrial fibrillation: a meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Pulmonary vein isolation durability in a randomized trial comparing fluoroscopy-only vs. electroanatomic mapping strategies for pulmonary vein isolation with balloon-in-basket 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 · 2026Trial
- Pulsed field or cryoballoon ablation for paroxysmal atrial fibrillation-insights from acute and chronic electroanatomic remapping in the randomized SINGLE-SHOT CHAMPION trial.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 · 2026Trial
- Lesion Durability of the Second Generation Pentaspline Pulsed Field Ablation CatheterCirculation. Arrhythmia and electrophysiology · 2026Trial
- Safety and effectiveness of the first balloon-in-basket pulsed field ablation system for the treatment of atrial fibrillation: VOLT CE Mark Study 6-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 · 2025Trial
- Pulse field ablation in patients with paroxysmal and persistent atrial fibrillation using the circular multielectrode array catheter: first outcome data in a real-world prospective study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Comparison of Pentaspline Pulsed Field Ablation Catheter Mapping Modes to Assess Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation.Journal of cardiovascular electrophysiology · 2026Article
- Both Electrical Isolation and Lesion Homogeneity Should be Focused: Evidence From Repeat Atrial Fibrillation Ablation.Journal of cardiovascular electrophysiology · 2026Article
- How to Use a Variable Loop Circular Catheter to Perform Zero Fluoro Pulmonary Vein Isolation With Pulsed Field Ablation.Pacing and clinical electrophysiology : PACE · 2026Review
- Pulsed electric field for pulmonary vein isolation in paroxysmal atrial fibrillation: A multicenter experience comparing pentaspline and lattice-tip catheters.Heart rhythm O2 · 2026Article
- Combined Pulsed Field and Radiofrequency Ablation for Coexisting Atrial Tachycardia During or After Atrial Fibrillation Ablation. Interventional and Clinical Outcomes.Journal of cardiovascular electrophysiology · 2026Article
- Beyond speed: why "skin-to-skin" time should not define quality in atrial fibrillation ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- Pulsed field ablation for pulmonary vein isolation with or without posterior wall ablation in patients with persistent atrial fibrillation: a multicenter study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Pulmonary vein reconnection patterns after pentaspline pulsed field 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 · 2026Article
- Comparison of Two Pulsed Field Ablation Systems for Atrial Fibrillation: One-Year Outcomes From a Multicenter Registry.Journal of cardiovascular electrophysiology · 2026Article
- The clinical pathophysiology of atrial fibrillation: outstanding questions from bedside to bench and back.Physiological reviews · 2026Review
- The Utility of Higher Pulsed Field Ablation Applications for Atrial Fibrillation Ablation.Journal of cardiovascular electrophysiology · 2026Article
- Predictive value of peak left atrial reservoir strain combined with left atrial appendage flow velocity for atrial fibrillation recurrence after pulsed field ablation.BMC cardiovascular disorders · 2026Article
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Abstract
aimsInitial clinical studies of pulsed field ablation (PFA) to treat atrial fibrillation (AF) indicated a >90% durability rate of pulmonary vein isolation (PVI). However, these studies were largely conducted in single centres and involved a limited number of operators. We aimed to describe the electrophysiological findings and outcomes in patients undergoing repeat ablation after an initial PF ablation for AF. METHODS AND
resultsIn the MANIFEST-REDO study, we investigated patients who underwent repeat ablation due to clinical recurrence-AF or atrial tachycardia (AT)-following first-ever PVI with a pentaspline PFA catheter (Farawave, Boston Scientific Inc.). At 22 centres, 427 patients (age 64 ± 11 years; 37% female) were included. Of note, the recurrent arrhythmia leading to the repeat ablation was paroxysmal AF (51%), persistent AF (30%), or AT (19%). At the repeat procedure, the PV reconnection rates were 30% (left superior pulmonary vein), 28% (left inferior pulmonary vein), 33% (right superior pulmonary vein), and 32% (right inferior pulmonary vein). In 45% of patients, all PVs were durably isolated at the beginning of the repeat procedure, with the previous use of any imaging or mapping modality being univariately associated with durable PVI. After a post-redo follow-up period of 284 (90-366) days, the primary effectiveness endpoint (freedom from documented AF/AT lasting ≥30 s after 3-month blanking without class I/III antiarrhythmic drugs or symptoms) was achieved in 65% of patients, with significant differences between groups (PAF 65% vs. PersAF 56% vs. AT 76%; P = 0.04). Persistent AF as recurrent arrhythmia after the initial PFA ablation predicted AT/AF recurrence after repeat ablation [hazard ratio 1.241 (95% confidence interval 1.534-1.005); P = 0.045]. The procedural complication rate was 2.8%.
conclusionIn repeat procedures for AF/AT performed after an index procedure with PFA for AF, PV reconnections are not uncommon. Repeat procedures can be performed safely and with an acceptable subsequent success rate.
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