ReviewCirculation. Arrhythmia and electrophysiology2025
2025 International Expert Practical Guide on the Use of the Pentaspline Pulsed Field Ablation System in Atrial Fibrillation Ablation Procedures.
Review in Circulation. Arrhythmia and electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 4 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
- Intracardiac Echocardiography during Invasive Electrophysiological Procedures: a Scientific Statement of the European Heart Rhythm Association of the ESC, and the European Association of Percutaneous Cardiovascular Interventions of the ESC.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
- 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
- Peri-procedure and Mid-Long Term Effects of Pulsed Field Ablation vs. Thermal Ablation (Cryo- or Radiofrequency) on Autonomic Nervous System Function in Atrial Fibrillation: A Systematic and Quantitative Pooled-Analysis with Potential Implications for Patient Selection (The PULSE-COLD-HEAT-ANS Collaboration).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 · 2025Pooled it
- Pulsed-field ablation for refractory typical atrial flutter resistant to multiple radiofrequency ablations: A technical report.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Concomitant Pulsed Field Ablation and Left Atrial Appendage Occlusion for Atrial Fibrillation With Dextrocardia.JACC. Case reports · 2026Article
- Temperature as a "hidden dose" in pulsed field ablation: toward temperature-aware workflows and reproducible reporting.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Editorial commentary: Pulsed field versus thermal ablation for atrial fibrillation.Trends in cardiovascular medicine · 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
- Step-by-Step: How to Perform Pulsed Field Ablation of Atrial Fibrillation Guided Exclusively by Intracardiac Echocardiography Using a Pentaspline Catheter.Journal of cardiovascular electrophysiology · 2026Review
- The Role of Multimodality Imaging in Atrial Fibrillation and Heart Failure: From Patient Selection to Procedural Ablation Guidance.Medicina (Kaunas, Lithuania) · 2026Review
- Pulsed Field Ablation of Atypical Atrial Flutter in a Patient After Hybrid Ablation of Atrial Fibrillation.Clinical case reports · 2026Article
- Optimized workflow for pentaspline PFA and its impact on PVI durability: evidence from systematic remapping.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
- Convergent Hybrid Ablation Versus Catheter Ablation in Patients With Persistent Atrial Fibrillation and Heart Failure: HALT AF Study Protocol and Rationale for a Multicenter Randomized Controlled Trial.Journal of the American Heart Association · 2026Article
- Real-Time 3D Mapping Corrects Fluoroscopic Misperception During Pulmonary Vein Isolation by Pulsed Field Ablation.Journal of cardiovascular electrophysiology · 2026Article
- Pulsed-Field Ablation With a Persistent Left Superior Vena Cava: Potential for Transmural Ablation.JACC. Case reports · 2026Article
- Takotsubo Syndrome After Pulsed-Field Ablation for Atrial Fibrillation.JACC. Case reports · 2026Article
- Does hemolysis matter after pulsed field ablation for atrial fibrillation? Insights from the Best Ablate Registry.Heart rhythm O2 · 2026Article
- Unexpected acute kidney injury requiring dialysis after routine pulsed field pulmonary vein isolation: a case report.European heart journal. Case reports · 2026Article
- Management of patients with atrial tachycardia: a clinical consensus statement of the European Heart Rhythm Association (EHRA) of the ESC, endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), and the Association for European Paediatric and Congenital Cardiology (AEPC).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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
Abstract
Pulsed field ablation (PFA) has been developed as a largely nonthermal ablation technology with a unique biophysical profile to treat atrial fibrillation. Existing evidence has shown that PFA offers a safe and efficient atrial fibrillation ablation procedure. Among different PFA technologies, the pentaspline FARAPULSE system has been the most extensively used and investigated; however, notable variability exists in workflow, fluoroscopy time, and lesion durability. While innovations such as 3-dimensional electroanatomic mapping systems and intracardiac echocardiography can enhance procedural precision in catheter ablation, fluoroscopy remains the primary imaging modality for guiding pentaspline PFA in many electrophysiology labs worldwide. This is particularly true in centers where limitations in cost, infrastructure, or training may preclude the routine use of advanced imaging technologies. This article summarizes general practical considerations and presents a primarily fluoroscopy-based, refined workflow developed by a group of experts. The goal is to provide a procedural foundation and practical guide for using the pentaspline FARAPULSE PFA system in atrial fibrillation ablation procedures. Developing a fluoroscopy-based practical guide would: (1) Democratize access to PFA technology, enabling safe and effective implementation across a broader range of clinical settings, including those without intracardiac echocardiography or 3-dimensional mapping support; (2) Reduce procedural heterogeneity by offering reproducible best practices; (3) Facilitate meaningful intercenter comparisons of procedural efficacy and safety, aiding in the identification of optimal approaches and improving the quality of clinical data for ongoing research, registries, and real-world performance monitoring of PFA technologies; and (4) Ultimately improve patient outcomes through standardized, accessible, and evidence-based practices.
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Registered trials
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