ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Near-zero fluoroscopy workflow for pulmonary vein isolation in atrial fibrillation using a variable loop, 3D-integrated circular PFA catheter (Varipulse™): initial single-center experience with the first 35 patients.
Article 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. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Fluoroless Workflow for Pulsed Field Ablation of Atrial Fibrillation Using the Sphere-9 and VARIPULSE Catheters.Journal of clinical medicine · 2026Review
- 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-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
- Zero/Low-fluoroscopy pulsed-field ablation approach: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Review
- When low is not low enough: zero-fluoroscopy atrial fibrillation ablation using the VARIPULSE™ pulsed field system-a prospective single-center study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Real-world strategies for pulsed field ablation using a variable-loop circular catheter: a compendium of best practices from early adopters.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Single-Center Real World Experience with the VARIPULSE Platform for Pulsed Field Ablation of Atrial Fibrillation, Atrial Flutter, and Redo Procedures.Journal of clinical medicine · 2025Article
- Pulsed-Field Ablation Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2025Review
- How to: Streamlining Pulsed Field Ablation-Based Pulmonary Vein Isolation Using 3D Mapping Without Fluoroscopy.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCatheter ablation is a standard atrial fibrillation (AF) treatment, traditionally using radiofrequency (RF) or cryoablation, which carries the risk of damaging nearby structures. Pulsed field ablation (PFA) offers partly tissue-selective energy application with minimal collateral damage. This study evaluated a near-zero fluoroscopy workflow with the novel VARIPULSE™ catheter, combining advanced mapping for optimized PFA delivery and reduced radiation. Here, we investigate the safety, efficiency, and effectiveness of this approach in the first 35 patients treated.
objectiveThis study aimed to assess the procedural characteristics, safety, and acute efficacy of pulmonary vein isolation (PVI) using the VARIPULSE™ PFA catheter in patients with AF, while specifically evaluating a near-zero fluoroscopy workflow to minimize radiation exposure during the procedure.
methodsThirty-five consecutive patients with paroxysmal or persistent AF underwent pulmonary vein isolation (PVI) using the VARIPULSE™ PFA catheter. Procedures were conducted under general anesthesia or deep sedation. Key procedural endpoints included acute pulmonary vein isolation, total procedure time, left atrial (LA) dwell time, fluoroscopy time and dose, and safety outcomes, with a focus on assessing the feasibility of a near-zero fluoroscopy workflow.
resultsThirty patients underwent near-zero fluoroscopy atrial fibrillation ablation using the novel VARIPULSE™ Pulsed Field Ablation catheter. Patients had a median age of 70 years and typical cardiovascular comorbidities, with 54% presenting with paroxysmal AF. Thirty-three of 35 patients (94%) had a normal left ventricular systolic function (> 60%). The median CHA
conclusionThe VARIPULSE™ Pulsed Field Ablation system enables an efficient, nearly fluoroscopy-free atrial fibrillation ablation with a simple, easily integrable workflow in the electrophysiology lab. Complete pulmonary vein isolation was achieved in all cases without radiofrequency touch-ups, and the procedure was safe with no major complications. This demonstrates the potential for widespread adoption of this technology and workflow.
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