Does adjunctive left atrial posterior wall isolation using pulsed-field ablation improve arrhythmia-free survival in patients undergoing repeat catheter ablation for atrial fibrillation?
In patients undergoing repeat ablation for atrial fibrillation, adding posterior wall isolation using pulsed-field ablation to redo PVI increases procedure time without improving arrhythmia-free survival.
Redo PVI with or without adjunctive PWI is safe and effective, with comparable arrhythmia-free survival. Adjunctive PWI prolongs procedural duration without improving outcomes. Randomized trials are required to clarify its role.
Badertscher et al. (2026) studied this question.