ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2025
Anterior mitral isthmus line using pulsed-field ablation with the pentaspline catheter or radiofrequency ablation: procedural characteristics, safety, and mid-term outcomes.
Article in 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 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
- Hybrid pentaspline pulsed-field and radiofrequency ablation for left atrial mitral isthmus block: Acute and long-term outcomes.Heart rhythm O2 · 2026Article
- Prolonged atrioventricular block after left atrial anteroseptal pulsed field ablation with a Pentaspline catheter in a patient with pre-existing bifascicular block and prior cardiac surgery.HeartRhythm case reports · 2026Article
- Pulsed field ablation: from technological breakthrough to structured clinical implementation-the role of the European Heart Rhythm Association.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
- Catheter Ablation for Persistent Atrial Fibrillation: Rationale, Evidence, and Contemporary Strategies Beyond Pulmonary Veins.Journal of clinical medicine · 2026Review
- Advent of Pulsed Field Ablation for Atrial Fibrillation: State-of-the-Art Review.Reviews in cardiovascular medicine · 2025Review
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14 authors.
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Abstract
aimsPulsed-field ablation (PFA) is a non-thermal energy source for pulmonary vein isolation (PVI), offering advantages in safety and procedural efficiency. However, data comparing anterior mitral isthmus line (MIL) ablation using PFA vs. conventional radiofrequency ablation (RFA) are scarce. This study aimed to compare procedural characteristics, safety, and arrhythmia recurrence following PVI with additional anterior MIL ablation using PFA vs. RFA. METHODS AND
resultsIn this prospective, single-centre analysis from the SWISS-AF-PVI registry, 129 patients (median age 70 years, 40% female) undergoing PVI with anterior MIL ablation were included. Patients received either PFA with a pentaspline catheter (n = 61) or RFA using a 3.5 mm irrigated tip catheter (n = 68). Procedural parameters, complications, and arrhythmia recurrence were assessed over a median follow-up of 327 days. PFA significantly reduced total procedure time (71 vs. 108 min, P < 0.001), LA dwell time (53 vs. 80 min, P < 0.001), and ablation time (27 vs. 50 min, P < 0.001) compared to RFA. MIL ablation with PFA required fewer applications (14; 35 s vs. 473 s RFA, P < 0.001). Arrhythmia-free survival was similar between groups (PFA 48.8% vs. RFA 61.8%, P = 0.34). Among 34 patients undergoing redo procedures, incomplete MIL was found in 53%, with no significant difference between groups. Three major complications occurred.
conclusionAnterior MIL ablation using PFA is feasible, safe, and more time-efficient than RFA, with comparable mid-term arrhythmia outcomes. However, high rates of MIL reconnection and arrhythmia recurrence highlights the need to improve lesion durability.
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