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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Effect of Pulsed Field Ablation System and Post-Ablation Mapping on Atrial Fibrillation Recurrence
Benjamin J Behers1, Christoph A Stephenson-Moe1, Sammy Shihadeh2
1Florida State University Internal Medicine Residency at Sarasota Memorial Hospital, Sarasota, FL 34239, USA.
Journal of Cardiovascular Development and Disease
|June 25, 2026
Summary
Pulsed field ablation (PFA) for atrial fibrillation shows similar recurrence rates between two systems. However, increased fluoroscopy time significantly predicted higher recurrence rates, highlighting the need for optimized procedural efficiency.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Atrial fibrillation (AF) is a prevalent arrhythmia linked to increased morbidity and mortality.
- Catheter ablation effectively reduces AF burden, with pulsed field ablation (PFA) emerging as a safer alternative to thermal ablation.
- Two distinct PFA systems, PulseSelect™ (circular) and FARAPULSE™ (pentaspline), are available for AF treatment.
Purpose of the Study:
- To compare clinical outcomes, specifically recurrence rates, between the PulseSelect™ and FARAPULSE™ PFA systems in patients with AF.
- To investigate the impact of post-ablation mapping with a high-density mapping catheter (PAHDMC) and procedural parameters (procedure time, fluoroscopy time) on AF recurrence after PFA.
Main Methods:
- A comparative study involving 895 patients undergoing PFA for AF.
- Analysis of recurrence rates based on the PFA system used (circular vs. pentaspline).
- Evaluation of the influence of PAHDMC use and procedure/fluoroscopy times on recurrence, with a median follow-up of 12.5 months.
Main Results:
- Overall AF recurrence rate was 39% across all patients.
- No significant difference in recurrence rates was observed between the two PFA systems, PAHDMC use, or procedure time.
- Increased fluoroscopy time emerged as a significant predictor of recurrence, particularly in the pentaspline catheter group.
Conclusions:
- PFA is a viable option for AF ablation, with comparable recurrence rates between the evaluated circular and pentaspline catheter systems.
- Procedural efficiency, specifically minimizing fluoroscopy time, is crucial for reducing AF recurrence post-PFA.
- Further research is warranted to compare PFA systems and assess the benefits of PAHDMC in optimizing PFA outcomes.
