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Updated: Sep 11, 2025

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Posterior Wall Involvement During Pulmonary Vein Isolation Using the Farapulse System.

Maria Teresa Izquierdo de Francisco1, Josep Navarro-Manchon1, Oscar Cano Perez1

  • 1Electrophysiology Section, Cardiology Department Hospital Universitari i Politecnic La Fe Valencia Spain.

Journal of Arrhythmia
|August 11, 2025
PubMed
Summary

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Insights into the optimal blanking period after pulmonary vein isolation with radiofrequency or pulsed-field ablation.

Revista espanola de cardiologia (English ed.)·2025
This summary is machine-generated.

The Farapulse Pulsed-Field-Ablation system created narrow corridors in 40% of patients undergoing pulmonary vein isolation. Inter-carina line length predicted these narrow corridors, but they did not increase atrial fibrillation recurrence.

Area of Science:

  • Electrophysiology
  • Cardiac Ablation Technologies
  • Atrial Fibrillation Treatment

Background:

  • The Farapulse Pulsed-Field-Ablation (PFA) system is the first approved PFA system for pulmonary vein isolation (PVI).
  • Assessing lesion characteristics and clinical outcomes of the Farapulse PFA system is crucial for understanding its efficacy and safety.

Purpose of the Study:

  • To evaluate the characteristics of lesions created by the Farapulse PFA system during PVI.
  • To determine the influence of these lesion characteristics on clinical outcomes, specifically atrial fibrillation recurrence.

Main Methods:

  • Seventy-six consecutive patients undergoing PVI with the Farapulse PFA system were analyzed.
  • Pre- and post-ablation voltage and activation mapping were performed to assess lesion formation.
Keywords:
posterior wallpulmonar vein isolationpulsed field ablation

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  • Defined narrow corridors (<20mm) and posterior wall fusion based on ablation area connectivity and voltage thresholds.

    • Main Results:

    • Post-ablation mapping revealed a narrow corridor in 15% and posterior wall fusion in 23% of patients.
    • The length of the middle inter-carina line was the sole independent predictor of narrow corridors or fusion.
    • A shorter middle posterior line length (<65mm) predicted narrow corridors with 80% sensitivity and 70% specificity (AUC: 0.82).

    Conclusions:

    • Approximately 40% of patients exhibited narrow corridors or fusion on the posterior wall after PVI with the Farapulse system.
    • The length of the inter-carina line is a significant predictor of these anatomical findings.
    • Neither narrow corridors nor fusion were associated with increased atrial fibrillation recurrence in this cohort.