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February 25, 2026Journal of Cardiovascular Electrophysiology3 citationsOpen Access

Pulsed Field Versus Radiofrequency Ablation in Concomitant Pulmonary Vein Isolation and LAA Occlusion: Impact on Peridevice Leak and Procedural Efficiency

MAMohammad Montaser AtasiSHShea HubbardCCCharles Campbell

Key Result

Pulsed field ablation plus LAA occlusion reduced peridevice leak incidence and procedural time compared to radiofrequency ablation plus LAA occlusion without safety loss.

Key Points

  • The aim is to compare the effectiveness of pulsed field ablation (PFA) against radiofrequency ablation (RFA) in reducing peridevice leaks during specific heart procedures.
  • Compared outcomes of concomitant PFA and left atrial appendage occlusion (LAAO) with RFA and LAAO.
  • Measured incidence of peridevice leaks and procedural times.
  • Evaluated safety parameters associated with both techniques.
  • PFA resulted in a lower incidence of peridevice leaks compared to RFA.
  • Procedural times were shorter with PFA than with RFA.
  • Safety was maintained without significant differences between the two ablation methods.

Structured PICO

Does concomitant pulsed field ablation and LAAO reduce peridevice leak and procedural duration compared to radiofrequency ablation and LAAO in patients with atrial fibrillation?

P
Population
175 consecutive patients with atrial fibrillation and 2 or more risk factors for stroke undergoing left atrial appendage occlusion (LAAO) with or without concomitant pulmonary vein isolation. Excluded: prior LAAO, incomplete procedural data, or unavailable follow-up imaging. US-based single-center cohort.
I
Intervention
Concomitant pulsed field ablation (PFA) for pulmonary vein isolation and left atrial appendage occlusion (LAAO) using WATCHMAN FLX or WATCHMAN FLX PRO devices
C
Comparator
Concomitant radiofrequency ablation (RFA) and LAAO, or LAAO-only procedure
O
Outcome
Peridevice leak (PDL) at 45-day follow-up transesophageal echocardiography (TEE)surrogate

Concomitant pulsed field ablation and LAAO is associated with a lower incidence of peridevice leak and shorter procedural times compared to radiofrequency ablation, without compromising safety.

Limitations

  • Single center with a modest sample size
  • Baseline differences between groups (younger age and lower CHA2DS2-VASc in RFA group)
  • Short follow-up limited to 45 days
  • Nonrandom device selection (WATCHMAN FLX PRO used predominantly in the PFA group)

Abstract

Concomitant PFA + LAAO is associated with lower PDL incidence and shorter procedural times compared with RFA + LAAO, without compromising safety.

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Cite This Study

Atasi et al. (2026) studied this question. Pulsed field ablation plus LAA occlusion reduced peridevice leak incidence and procedural time compared to radiofrequency ablation plus LAA occlusion without safety loss.

synapsesocial.com/papers/699e912ef5123be5ed04e904https://doi.org/10.1111/jce.70286
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