Recommended Citation
Nallamala H, Erickson L, Kanani J, et al. Multicenter Analysis of Pulsed Field Ablation Freedom from Atrial Arrythmias by Lesion Set in Paroxysmal Atrial Fibrillation. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Catheter ablation via pulmonary vein isolation (PVI) is the first-line treatment for paroxysmal atrial fibrillation (PAF). It is unclear whether additional lesions with PVI using the pulsed field ablation (PFA) technique affect outcomes in this population.
Purpose:
We aimed to assess freedom from atrial arrythmias in patients with PAF stratified by lesion set at 12 months.
Methods:
From March 2024 to July 2024, PAF patients (n=184) from 4 different centers within a hospital system underwent first-time ablation with PFA. Recurrence was defined as any atrial arrhythmia ≥30 seconds in duration after a 90-day blanking period. Patients were divided into 2 groups: PVI only (PVI) (78, 42%) and PVI plus additional lesions in the left atrium (PVI plus) (106, 58%). A chi-square test was used for categorical variables, and the Wilcoxon rank-sum test was used for continuous variables. A Kaplan-Meier estimate was used to analyze freedom from recurrence in the PVI and PVI plus.
Results:
Median (IQR) age (years) was 64 (56, 69) in PVI and 68 (63, 75) in PVI plus (p=0.0002). Hypertension was significantly higher in PVI plus (77, 73%) compared to PVI (44, 56%), p=0.02. The mean (SD) CHA2DS2-VASc score was significantly higher in PVI plus (2.72 ±1.61) vs PVI (2.03 ±1.45), p=0.006. Additional baseline characteristics sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, cerebrovascular accident, obstructive sleep apnea, valvular heart disease, congestive heart failure, prior anti-arrhythmic drug use and left atrial volume index were similar (p>0.05). There was no difference in recurrence at 12 months between groups from the four centers (p=0.71).
Conclusion:
Findings at 12 months suggested additional lesions may not affect freedom from atrial arrhythmia recurrence, but future multivariate analysis is warranted. Randomized studies are needed to validate these results.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Multicenter Analysis of Pulsed Field Ablation Freedom from Atrial Arrythmias by Lesion Set in Paroxysmal Atrial Fibrillation
Background/Significance:
Catheter ablation via pulmonary vein isolation (PVI) is the first-line treatment for paroxysmal atrial fibrillation (PAF). It is unclear whether additional lesions with PVI using the pulsed field ablation (PFA) technique affect outcomes in this population.
Purpose:
We aimed to assess freedom from atrial arrythmias in patients with PAF stratified by lesion set at 12 months.
Methods:
From March 2024 to July 2024, PAF patients (n=184) from 4 different centers within a hospital system underwent first-time ablation with PFA. Recurrence was defined as any atrial arrhythmia ≥30 seconds in duration after a 90-day blanking period. Patients were divided into 2 groups: PVI only (PVI) (78, 42%) and PVI plus additional lesions in the left atrium (PVI plus) (106, 58%). A chi-square test was used for categorical variables, and the Wilcoxon rank-sum test was used for continuous variables. A Kaplan-Meier estimate was used to analyze freedom from recurrence in the PVI and PVI plus.
Results:
Median (IQR) age (years) was 64 (56, 69) in PVI and 68 (63, 75) in PVI plus (p=0.0002). Hypertension was significantly higher in PVI plus (77, 73%) compared to PVI (44, 56%), p=0.02. The mean (SD) CHA2DS2-VASc score was significantly higher in PVI plus (2.72 ±1.61) vs PVI (2.03 ±1.45), p=0.006. Additional baseline characteristics sex, race/ethnicity, body mass index, diabetes mellitus, coronary artery disease, cerebrovascular accident, obstructive sleep apnea, valvular heart disease, congestive heart failure, prior anti-arrhythmic drug use and left atrial volume index were similar (p>0.05). There was no difference in recurrence at 12 months between groups from the four centers (p=0.71).
Conclusion:
Findings at 12 months suggested additional lesions may not affect freedom from atrial arrhythmia recurrence, but future multivariate analysis is warranted. Randomized studies are needed to validate these results.
Affiliations
Aurora St. Luke's Medical Center, Aurora Sinai Medical Center