What is the clinical evidence from this study?

Study design: Observational. Population: Symptomatic paroxysmal or persistent atrial fibrillation (n=178). Intervention: Catheter ablation using the circular multielectrode PFA system (PulseSelect). Primary outcome: Freedom from recurrent atrial arrythmia at 1 year.

What question did this study set out to answer?

The study aims to assess the safety, feasibility, and effectiveness of pulmonary vein isolation (PVI) with/without posterior wall isolation (PWI) in atrial fibrillation patients.

June 8, 2026

Pulmonary Vein and Posterior Wall Isolation Using the Circular Multielectrode Catheter for Treatment of Atrial Fibrillation: Acute and Long-Term Outcomes from Pulsed FiEld Ablation foR PVI Using PulSESElect with Adjunct POsterior WalL ISolation (PERSEPOLIS) Trial

Q: What does this research mean for the field?

Pulmonary vein isolation with or without posterior wall isolation using the circular multielectrode pulsed-field ablation catheter is safe and effective in patients with symptomatic paroxysmal and persistent atrial fibrillation, demonstrating high acute success and low complication rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Catheter ablation using the circular multielectrode PFA system achieved 100% acute PVI, with 1-year freedom from recurrent atrial arrhythmia of 81.6% in paroxysmal and 66.6% in persistent AF.

Key Points

The study aims to assess the safety, feasibility, and effectiveness of pulmonary vein isolation (PVI) with/without posterior wall isolation (PWI) in atrial fibrillation patients.
Retrospective analysis of 178 patients with symptomatic paroxysmal/persistent AF undergoing catheter ablation using circular multielectrode pulsed-field ablation catheter.
Procedures included PVI or PVI+PWI based on operator discretion.
Assessment involved procedural outcomes, safety events, renal biomarkers, and atrial arrhythmia recurrence.
Acute pulmonary vein isolation achieved in 100% of patients (n=178).
Freedom from recurrent atrial arrhythmia at 1 year was 81.6% in paroxysmal and 66.6% in persistent AF.
Four (2.2%) adverse events were noted, with biomarkers resolving 48-72 hours post-ablation.

Study Design

Type

Observational (n=178)

Structured PICO

Does catheter ablation using the circular multielectrode pulsed-field ablation system prevent atrial arrhythmia recurrence in patients with symptomatic paroxysmal or persistent atrial fibrillation?

Population

178 patients (mean age 69, 38% female) with symptomatic paroxysmal or persistent atrial fibrillation undergoing catheter ablation using a circular multielectrode PFA catheter, followed for 1 year.

Exposure

Catheter ablation using the circular multielectrode pulsed-field ablation (PFA) system for pulmonary vein isolation (PVI) with or without posterior wall isolation (PWI) (96.6% received PVI+PWI)

Outcome

Procedural outcomes, safety events, renal biomarkers, and atrial arrythmia recurrence at 1 year

Pulsed-field ablation using a circular multielectrode catheter is safe and effective for pulmonary vein isolation with or without posterior wall isolation in patients with atrial fibrillation, showing high acute success and low complication rates.

Abstract

BACKGROUND: Real-world outcomes on catheter ablation of atrial fibrillation (AF) using the circular multielectrode (PulseSelect, Medtronic) pulsed-field ablation (PFA) system remain sparse. OBJECTIVE: This study evaluated the safety, feasibility, and efficacy of pulmonary vein isolation (PVI) with/without posterior wall isolation (PWI) using the circular multielectrode PFA system. METHODS: We retrospectively analyzed the outcomes of consecutive patients with symptomatic paroxysmal/persistent AF, who underwent catheter ablation using the circular multielectrode PFA catheter. Patients underwent PVI or PVI+PWI at operators' discretion. Procedural outcomes, safety events, renal biomarkers, and atrial arrythmia recurrence were assessed. RESULTS: Altogether, 178 patients (age: 69±11 years; 62% male; 61% paroxysmal AF) underwent AF ablation using the circular multielectrode PFA catheter between 2/2024 and 8/2024 using 62±17 PFA application (procedure time: 66±11 min, fluoroscopy time: 14±5 min). Acute PVI was achieved in 100% (n=178), and 96.6% of patients (n=172) received PVI+PWI. Four (2.2%) adverse events (2 minor) were encountered. Analysis of biomarkers demonstrated an increase in serum total bilirubin (1.01mg/dL; 95% CI: 0.84, 1.17, P<0.001) 2 h post-ablation and stage 1 acute kidney injury in one patient with a history of chronic kidney disease. All changes in biomarkers resolved spontaneously within 48-72h without clinical sequelae. Freedom from recurrent atrial arrythmia was 81.6% in paroxysmal and 66.6% in persistent AF patients at 1 year. CONCLUSION: These real-world results demonstrate that PVI with/without PWI using the circular multielectrode array PFA catheter is safe, feasible, and effective in patients with symptomatic paroxysmal and persistent AF with a low risk of complications, including hemolysis.

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