101 Is pulsed field ablation better tolerated? - A comparative study of patient experience after af ablation using pulsed field, radiofrequency and cryoballoon ablation

Background Pulsed field ablation (PFA) is a novel non-thermal ablation treatment for atrial fibrillation (AF). In addition to the emerging safety and efficacy data from early adopters of PFA for AF ablation, there is a growing perception that PFA is better tolerated by patients than established ablation modalities. We sought to compare procedure-related patient symptoms following PFA, radiofrequency (RF) and cryoballoon ablation. Methods We prospectively enrolled 120 patients (age: 65 ±10: female 32%) with paroxysmal or early persistent AF from 3 institutions who underwent pulmonary vein isolation (PVI) using PFA, RF or cryoballoon ablation between November 2022 and October 2023, with 40 age- and sex-matched patients per group. Patient symptom scores were collected at 24-hours and 7-days post ablation for chest pain, breathlessness, palpitations, sore throat, groin pain and fatigue, each graded using a 5-point Likert scale. Statistical analysis was performing using Kruskal-Wallis test and thereafter the Dunn-Bonferroni post-hoc test. Results Patients reported a greater degree of procedure-related symptoms in the cryoballoon cohort at 24 hours post-procedure, which mostly improved by day 7 (figures 1 and 2). The median symptom scores were significantly higher (p<0.05) in the cryoballoon cohort than in the PFA and RF cohort for chest pain, breathlessness, palpitations, sore throat and groin pain. There was no significant difference between PFA and RF patients across the symptom domains. Conclusion PVI using either PFA or RF ablation appears better tolerated than cryoballoon ablation in the immediate and early post-procedure recovery period. Conflict of Interest Nil