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Updated: Jun 28, 2026
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Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
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
Summary
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.
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.
