What question did this study set out to answer?

This case aims to document the interaction between a leadless pacemaker and monopolar pulsed field ablation during pulmonary vein procedures.

January 17, 2026Journal of Cardiovascular Electrophysiology

Acute Atrial Pacing Threshold Elevation in an Auricular Leadless Pacemaker During Monopolar Pulsed Field Ablation of the Right Inferior Pulmonary Vein: A First‐in‐Human Case

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Key result

Monopolar PFA transiently increases AVEIR leadless pacemaker thresholds, recovering within 24 hours.

Why the study?

Leadless atrial pacemakers are increasingly used, but their interactions with pulsed field ablation remain poorly described.

Does monopolar pulsed field ablation interfere with atrial leadless pacemakers?

Population

1 patient with an AVEIR leadless pacemaker undergoing right inferior pulmonary vein ablation

Design

Case report

Follow-up

24 h

Authors

JDJorge O. DíazAdventHealth Orlando USU SiddiquiAdventHealth Orlando CACarlos E. ArenasIndustrial University of Santander

Discussion

Member takes

Implication

May warrant periprocedural monitoring of leadless pacemakers during monopolar PFA; hypothesis-generating for device interactions.

Key Points

This case aims to document the interaction between a leadless pacemaker and monopolar pulsed field ablation during pulmonary vein procedures.
Documented a first case of pacing threshold elevation during PFA on an AVEIR leadless pacemaker.
Monopolar PFA was performed on the right inferior pulmonary vein.
Pacing thresholds were measured before, during, and after the procedure.
Pacing threshold increased from 0.75 V @ 0.2 ms to 1.25 V @ 0.4 ms during PFA.
The loss of capture occurred transiently and recovered within 24 hours.
The findings suggest the potential for temporary interference with leadless pacemakers during ablation.

Structured PICO

Does monopolar pulsed field ablation interfere with atrial leadless pacemakers?

Population

1 patient with an AVEIR leadless atrial pacemaker undergoing right inferior pulmonary vein ablation

Intervention

Monopolar pulsed field ablation (PFA)

Outcome

Pacing threshold elevation and loss of capturesafety

Monopolar pulsed field ablation can cause transient loss of capture and pacing threshold elevation in atrial leadless pacemakers, highlighting the need for device monitoring during the procedure.

Cite This Study

Díaz et al. (2026) studied this question. Monopolar pulsed field ablation increased the pacing threshold of an AVEIR leadless pacemaker from 0.75 V to 1.25 V, recovering within 24 hours.

synapsesocial.com/papers/696b2631d2a12237a934977f https://doi.org/10.1111/jce.70259

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Acute Atrial Pacing Threshold Elevation in an Auricular Leadless Pacemaker During Monopolar Pulsed Field Ablation of the Right Inferior Pulmonary Vein: A First‐in‐Human Case

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Acute Atrial Pacing Threshold Elevation in an Auricular Leadless Pacemaker During Monopolar Pulsed Field Ablation of the Right Inferior Pulmonary Vein: A First‐in‐Human Case

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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