Related Experiment Video
Updated: Aug 14, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Pulsed Field Ablation for Atrial Fibrillation in Obesity: Reassessing Risk, Safety, and Success
Ridwan R Waliyuddin1,2, Dony Y Hermanto1,2, Sunu B Raharjo1,2
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 11420, Indonesia.
Journal of Clinical Medicine
|August 13, 2026
Summary
Pulsed field ablation (PFA) shows promise for treating atrial fibrillation (AF) in obese patients, with outcomes comparable to traditional methods. Further research is needed to confirm its long-term effectiveness and safety in this population.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Obesity is a significant risk factor for atrial fibrillation (AF), complicating management and treatment outcomes.
- Conventional thermal ablation techniques face challenges in obese patients, potentially limiting efficacy.
- Pulsed field ablation (PFA), a novel non-thermal ablation modality, offers a potential alternative.
Purpose of the Study:
- To evaluate the outcomes of pulsed field ablation (PFA) in patients with atrial fibrillation (AF) who are overweight or obese.
- To compare PFA efficacy and safety against conventional ablation techniques (RFA, CBA) in this patient group.
- To identify predictors of recurrence following PFA in obese AF patients.
Main Methods:
- Systematic literature search of PubMed, Scopus, and Embase for observational cohort studies (2017-2026) on PFA in obese AF patients.
- Inclusion of four cohort studies evaluating PFA outcomes across different BMI categories.
- Comparison of PFA with radiofrequency ablation (RFA) and cryoballoon ablation (CBA) regarding recurrence, complications, and procedure time.
Main Results:
- Heterogeneous findings on AF recurrence with PFA; rates appeared lower than RFA but not statistically significant.
- No variation in arrhythmia recurrence-free survival across BMI categories in a PFA-only study.
- Left atrial epicardial adipose tissue (LA EAT) identified as the sole independent predictor of recurrence in PFA patients.
- Lower radiation exposure with PFA compared to CBA; comparable fluoroscopy times and periprocedural complications.
Conclusions:
- Current observational data suggest PFA is a feasible and safe option for AF ablation in overweight and obese individuals.
- Comparative efficacy and long-term safety of PFA versus conventional methods require further investigation.
- Obesity-related factors may influence electric field distribution and recurrence rates, necessitating larger prospective trials.
