Comparison of Two Pulsed Field Ablation Systems for Atrial Fibrillation: One-Year Outcomes From a Multicenter...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Pulsed field ablation (PFA) is emerging for atrial fibrillation (AF) treatment.
• Limited data exists comparing long-term efficacy of different PFA systems.

Purpose of the Study:

• To compare the long-term efficacy of two commercial PFA systems for pulmonary vein isolation (PVI) in AF patients.
• Evaluate recurrence rates and factors influencing them in a multicenter setting.

Main Methods:

• International, multicenter registry study of 428 AF patients undergoing first ablation.
• Treatment with either pentaspline or circular over-the-wire PFA catheters.
• Primary endpoint: time to atrial arrhythmia recurrence post-PVI after a 2-month blanking period.

Main Results:

• All patients achieved acute procedural success.
• 12-month AF recurrence rates were similar between pentaspline (34.1%) and circular (32.8%) catheters (p=0.93).
• Longer time since AF diagnosis and persistent AF were associated with recurrence.

Conclusions:

• Both PFA systems demonstrated comparable 12-month efficacy for primary PVI in AF patients.
• High acute success and similar long-term recurrence rates suggest equivalent performance.