Observational studyJournal of cardiovascular electrophysiology2025
Impact of Pulsed-Field Ablation on the Left Atrial Appendage Diameter-Insights From Intra-Procedural Echocardiography.
Observational study in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Focal Pulsed Field Ablation and Strategic Upsizing in Concomitant Atrial Fibrillation Ablation and Left Atrial Appendage Occlusion.JACC. Case reports · 2026Article
- Successful Strategy to Perform Pulmonary Vein Isolation and Left Atrial Appendage Closure Concomitantly.Journal of cardiovascular electrophysiology · 2026Article
- Impact of Pulsed-Field Ablation on the Left Atrial Appendage Diameter-Insights From Intra-Procedural Echocardiography.Journal of cardiovascular electrophysiology · 2025Observational
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Authors and funding
14 authors.
Funding
Abstract
introductionConcomitant pulmonary vein isolation (PVI) and left atrial appendage (LAA) occlusion (LAAO) have become frequently used therapies. Pulsed-field ablation (PFA), will likely be used for combined PVI plus LAAO procedures. However, there may be concerns regarding the malposition of the LAAO device attributed to the potential tissue edema after PVI.
aimWe aimed to compare the LAA's size before and after PVI performed with the pentaspline catheter, measured intraprocedural by intracardiac echocardiography or transesophageal echocardiography.
methodsWe conducted a multicenter, prospective, observational study investigating PVI using the Farapulse system. The anteroposterior diameter of the left-sided pulmonary vein (LPV), left atrial ridge, and LAA were measured before and after the PFA.
resultsWe enrolled 91 patients aged 63 ± 10 years, 36% were women, and 47% had paroxysmal AF. The most common comorbidities was hypertension (59%). Procedure time and left atrial dwell time were 65 (52-80) min, and 27 (24-32) min, respectively. The diameter of the LAA was not different before and after the PVI (15 [13-18] and 16 [13-19], respectively; p = 0.756). On the other hand, the diameter of the left atrial ridge (7 [6-8] and 8 [6-8]) and the LPV (13 [10-15] and 13 [11-15]) was smaller before ablation compared to the diameter after PVI (p < 0.0001 for both). No major complications occurred.
conclusionLAA anteroposterior diameter does not change after PVI with PFA. Although there is a significant change in the anteroposterior diameters of the LPV and the left atrial ridge, it does not seem clinically relevant. If significant edema formation is detected in a single case after PVI, postponing the LAAO procedure should be considered.
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