ArticleCirculation. Arrhythmia and electrophysiology2026
Characteristics of Recurrent Atrial Arrhythmias and Lesion Assessment Late After Pulsed Field Ablation of Atrial Fibrillation.
Article in Circulation. Arrhythmia and electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPulsed field ablation (PFA) is a novel and rapidly expanding energy for the ablation of atrial fibrillation (AF). The relationships between the characteristics of pulmonary vein (PV) and extra-PV PFA applications, and the type of arrhythmia recurrence or durable lesion observed during redo procedures remain unclear.
methodsIn this substudy of the FRANCE PFA national exhaustive multicentric registry, we collected detailed data on PFA applications delivered during the initial AF ablation procedure. Among patients with arrhythmia recurrence undergoing redo procedures with 3-dimensional mapping (n=145), we analyzed the type of recurrence, rates of durable PV isolation (PVI), and the presence of complete block over the ablation lines.
resultsRecurrent arrhythmias comprised AF in 58%, atrial tachycardia in 23%, and typical atrial flutter in 9%. AF was less frequently observed when initial ablation targeted extra-PV areas (45 versus 71%;
conclusionsIn patients undergoing redo procedures after an initial AF ablation using the pentaspline PFA catheter, AF was less frequently observed when ablation lesions were performed beyond PVs. A high rate of durable PVI or block was achieved with >12 PFA applications per PV and >16 for the roof/PW. Long-term durability of mitral isthmus block was poor using the Pentaspline PFA catheter.
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