ArticleInternational journal of cardiology. Heart & vasculature2025
Pulsed field ablation using a circular electrode array catheter in patients with atrial fibrillation: A workflow optimization study evaluating the role of mapping.
Article in International journal of cardiology. Heart & vasculature, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07621003 (PULSed Field Ablation for Atrial Fibrillation Using a Balloon for Early Intervention - Study - The "PULSE - Study"), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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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.
PULSed Field Ablation for Atrial Fibrillation Using a Balloon for Early Intervention - Study - The "PULSE - Study"
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Practical guide on the use of the PulseSelect pulsed field ablation system for atrial fibrillation ablation procedures.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
- Controlling pulsed field ablation efficacy during ablation procedures.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
- Recent highlights from theInternational journal of cardiology. Heart & vasculature · 2026Article
- Acute incomplete pulmonary vein isolation and unintended posterior wall ablation during pulsed field ablation: insights from high-density mapping.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
- 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
- Circular over-the-wire pulsed field ablation for atrial fibrillation: differences in outcomes between conscious sedation or general anesthesia.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Recent highlights from theInternational journal of cardiology. Heart & vasculature · 2025Article
- Real-world comparison of variable vs fixed-loop circular pulsed field ablation catheters: Acute outcomes including non-pulmonary vein ablation.Heart rhythm O2 · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pulsed field ablation (PFA) with a circular-electrode-array catheter (cPFA) has shown to be effective and safe. However, data on procedural workflow are limited. Objective: to analyze the process of streamlining cPFA-procedures including evaluation of fluoroscopy versus 3D-map guidance and lesion characteristics. Methods: Consecutive AF-patients underwent cPFA-based pulmonary vein isolation (PVI) in three phases (learning-phase-I: visualization of cPFA in 3D-map; phase-II: operator blinded to 3D-map with fluoroscopy-guidance only; phase-III: optimized mapping and ablation). Additionally, hemolysis-parameters were collected. Results: A total of 35 patients (57 % paroxysmal-AF, age 63.4 ± 9.4 years) were enrolled: n = 10 phase-I, n = 15 phase-II, n = 10 in phase III. Total procedure and fluoroscopy time was 51.9 ± 9.4 and 6.7 ± 3.1 min, respectively. First-pass PFA isolation-rate was lowest in the fluoroscopy-only phase-II (I:86 %, II:81 %, III:100 %, p = 0.0079). Insufficient PV ablation with remaining conduction occurred mostly anterior (n = 8/15, 53 %) and at the carina (n = 4/15; 27 %). Following additional PFA, all 142 PVs (100 %) were acutely isolated.Procedure times between phase II and III did not differ (49 ± 8 vs. 46 ± 3 mins p = 0.23). Fluoroscopy times were longer in phase-II (phase-I: 5.8 ± 1.3, phase-II: 9.2 ± 2.9, phase-III: 3.8 ± 1.0 mins, p < 0.0001). No complications occurred. Pre- and post-ablation hemoglobin (14.4 ± 1.4 vs. 13.5 ± 1.2 g/dl, p = 0.0169) and LDH (188 ± 39 vs. 210 ± 29 U/l, p = 0.0007) were different. Conclusion: The cPFA-catheter allows for fast and efficient PVI. A fluoroscopy-only approach creates distal PV ablation lesions that are associated with residual PV conduction along the carina and anterior antrum. However, with visualization and mapping, creation of wide antral ablation lesions is feasible without prolonging procedural duration.
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