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  1. Home
  2. Pvi Durability After Pfa Or Rfa In Persistent-af: Insights From A Mandated Prospective Remapping Study.
  1. Home
  2. Pvi Durability After Pfa Or Rfa In Persistent-af: Insights From A Mandated Prospective Remapping Study.

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PVI Durability After PFA or RFA in Persistent-AF: Insights From a Mandated Prospective Remapping Study.

Oskar M Galuszka1, Thomas Kueffer1, Samuel H Baldinger1

  • 1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

JACC. Clinical Electrophysiology
|June 26, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Pulsed field ablation (PFA) shows durable pulmonary vein isolation (PVI) comparable to radiofrequency ablation (RFA) in persistent atrial fibrillation (AF). Recurrence rates were similar, indicating non-PV mechanisms may drive AF after PVI.

Keywords:
persistent atrial fibrillationpulmonary vein isolationpulsed-field ablationradiofrequency ablationremapping study

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Pulmonary vein isolation (PVI) is crucial for atrial fibrillation (AF) ablation.
  • Reconnections and non-pulmonary vein (PV) mechanisms contribute to persistent AF recurrence after ablation.

Purpose of the Study:

  • To compare the durability of PVI and arrhythmia recurrence rates between pulsed field ablation (PFA) and radiofrequency ablation (RFA) in patients with persistent AF.

Main Methods:

  • Prospective enrollment of persistent AF patients undergoing PVI.
  • Mandatory remapping at 6 months, with RFA used in phase 1 (n=30) and PFA in phase 2 (n=30).
  • 1-year follow-up with Holter monitoring; primary endpoints were PVI durability and arrhythmia recurrence.

Main Results:

  • PVI durability was comparable: 76% with RFA and 79% with PFA (P=0.77).
  • Overall PVI durability was 51% across both groups.
  • One-year freedom from recurrence was 70% with no significant difference between PFA and RFA (P=0.71).

Conclusions:

  • Pulsed field ablation offers PVI durability comparable to radiofrequency ablation in persistent AF.
  • A significant proportion of patients with durable PVI experienced recurrence, suggesting non-PV drivers.
  • Further investigation into non-PV mechanisms is warranted for persistent AF management.