Pulsed-field Ablation for Paroxysmal and Persistent Atrial Fibrillation: A Single-center Experience

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Atrial fibrillation (AF) poses significant health risks, and traditional ablation methods have limitations.
• Pulsed-field ablation (PFA) offers a novel, nonthermal approach to cardiac ablation, aiming to preserve surrounding tissues.
• This study details the initial clinical experience and learning curve with PFA at Prince Sultan Cardiac Center.

Purpose of the Study:

• To evaluate the safety and efficacy of pulsed-field ablation (PFA) for treating patients with atrial fibrillation (AF).
• To assess the initial learning curve and procedural outcomes associated with PFA in a clinical setting.

Main Methods:

• A retrospective analysis of 33 patients with paroxysmal or persistent AF undergoing PFA between 2022 and 2023.
• Outcomes assessed included procedural data, short-term and follow-up complications, and AF recurrence rates.

Main Results:

• The study included 33 patients (72.73% male, mean age 48.52 years) with common comorbidity of hypertension (33.33%).
• No procedural or early follow-up complications were reported; one patient experienced AF recurrence, and another developed atrial flutter requiring subsequent ablation.
• Key procedural metrics included left atrial ablation time (45.38 ± 17.96 min) and fluoroscopy time (33.45 ± 15.60 min).

Conclusions:

• Pulmonary vein isolation using PFA appears to be a safe and effective option for both paroxysmal and persistent AF.
• Long-term studies are recommended to compare PFA outcomes with existing ablation techniques.