ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
Pulsed-field ablation beyond pulmonary vein for persistent atrial fibrillation: efficacy and impact on left atrial function.
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 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline 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
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- Ablation of visually identified spatiotemporal dispersion plus pulmonary vein isolation in persistent atrial fibrillation.European heart journal open · 2026Article
- Pulsed-Field Ablation Circular Catheter Use in Left Superior Vena Cava-Associated Atrial Arrhythmias.JACC. Case reports · 2025Article
- Controversy: pulsed field ablation is the standard technique for all the candidates for atrial fibrillation 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 · 2025Review
- Epidemiology, pathophysiology, diagnosis and management of atrial functional mitral regurgitation: An expert opinion paper.ESC heart failure · 2025Review
- Pulsed field ablation preserves left atrial volume compared to radiofrequency in persistent atrial fibrillation ablation beyond pulmonary veins.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
- Closing Editorial for the Special Issue: Cardiac Electrophysiology and Catheter Ablation of Different Arrhythmias.Journal of clinical medicine · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulsed field ablation (PFA) is a novel, non-thermal energy for atrial fibrillation (AF) catheter ablation that selectively targets cardiomyocytes with minimal to no risk of collateral damage. Among ablation strategies in persistent AF (PersAF), targeting sites other than the pulmonary veins (PVs) remains controversial, with concerns on improved success without increasing the risk of periprocedural complications and stiff left atrium (LA) syndrome. This study evaluates the impact of an ablation strategy beyond PVs using PFA on arrhythmia freedom and LA function in PersAF patients.
methodsThis study included 93 patients with PersAF undergoing first-time PFA targeting PVs and other extra-PV targets. AF-related symptoms, adverse events, electrocardiograms, and transthoracic echocardiograms were assessed at follow-up visits at 1, 6, and 12 months.
resultsExtra-PV targets included posterior wall (100%), anterior roof (50.5%), mitral isthmus (22.6%), anterior wall (36.6%), and right atrium applications (8.6%). No serious procedure-related adverse events were reported. At 1-year follow-up, 82.8% of patients were free from atrial arrhythmias. PFA significantly reduced A-wave velocity of mitral inflow and altered the E/A ratio but did not change LA compliance markers (e.g., LA strain reservoir and LA stiffness index (LASI)). LASI and left ventricular ejection fraction significantly improved from baseline in the PersAF > 3-month group.
conclusionsOne-year atrial arrhythmia freedom in PersAF patients after extensive PFA by means of a multielectrode catheter was high. Extra-PV ablation was safe, did not alter LA compliance but promoted a positive reverse remodeling with improved LA compliance and left ventricular systolic function.
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