ArticlePathophysiology : the official journal of the International Society for Pathophysiology2025
Pulsed-Field Ablation Is Associated with Lower Endothelial Injury and Procedure Time Compared to Cryoballoon Ablation in Paroxysmal Atrial Fibrillation.
Article in Pathophysiology : the official journal of the International Society for Pathophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Physiological Tissue Response to Pulsed-Field Ablation for Atrial Fibrillation: Insights from Biomarker Kinetics.Physiological research · 2026Article
- Combined pulsed field ablation and left atrial appendage occlusion in a patient with persistent atrial fibrillation and adenomyosis-related menorrhagia: case report and 1-year follow-up.European heart journal. Case reports · 2026Article
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9 authors.
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Abstract
backgroundThromboembolic events, though infrequent, remain a significant complication of atrial fibrillation (AF) ablation, largely related to endothelial damage. Cryoballoon (CB) and radiofrequency ablation can induce pro-coagulant responses, whereas pulsed-field ablation (PFA), a novel non-thermal electroporation-based technique, has shown tissue selectivity with potential endothelial-sparing effects.
methodsWe aimed to compare PFA and second-generation CB ablation regarding endothelial injury in patients with paroxysmal AF. In this single-center prospective observational study, 25 patients with paroxysmal drug-refractory AF underwent pulmonary vein isolation using either a pentaspline PFA catheter (n = 14) or a second-generation CB catheter (n = 11). Circulating von Willebrand factor antigen (vWF) levels were assessed before and after ablation as a biomarker of endothelial damage, alongside routine laboratory and echocardiographic parameters. Procedural characteristics were also analyzed.
resultsBaseline demographic, clinical, and echocardiographic data were comparable between groups. PFA was associated with significantly shorter skin-to-skin procedure time (59 vs. 94 min,
conclusionsPFA was associated with reduced endothelial injury and shorter procedural times compared with CB ablation, suggesting a potential advantage in lowering thromboembolic risk. These findings support the concept of PFA as an "endothelial sparing" ablation modality. However, the PFA procedure was associated with a significantly greater extent of myocardial injury, as reflected in circulating high-sensitivity cardiac troponin T values, compared to CB ablation (
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