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March 14, 2026Journal of Interventional Cardiac Electrophysiology0 citationsOpen Access

Efficacy and safety of a novel pulsed field ablation system in paroxysmal atrial fibrillation

QLQiming LiuHLHanxiong LiuXCXiaoshu Cheng

Key Result

Pulsed field ablation achieved a 12-month primary effectiveness success rate of 83.0% with zero major adverse events recorded.

Key Points

  • This study aimed to evaluate the efficacy and safety of a new pulsed field ablation system for treating paroxysmal atrial fibrillation.
  • Prospective, multicenter, single-arm study design
  • Enrolled 161 patients from seven medical centers in China
  • Used circular and linear PFA catheters with contact force-sensing
  • Primary endpoints included freedom from atrial tachyarrhythmia and MAEs
  • 100% of ablated lesions were electrically isolated
  • No repeat ablations occurred during the 90-day blanking period
  • 83.0% success rate for primary effectiveness at 12 months
  • 94.9% clinical success rate with no major adverse events

Structured PICO

Does a novel pulsed field ablation system with circular and linear contact force-sensing catheters safely and effectively prevent atrial tachyarrhythmia recurrence in patients with symptomatic paroxysmal atrial fibrillation?

P
Population
161 adults (aged 18-80 years) with symptomatic paroxysmal atrial fibrillation (PAF), left atrial diameter ≤ 5.0 cm, and left ventricular ejection fraction ≥ 40%, mean age 62.3, 50.3% male, from seven medical centers in China.
I
Intervention
A novel pulsed field ablation (PFA) system comprising a circular PFA catheter and a linear contact force (CF)-sensing PFA catheter, delivering biphasic voltage of 800-1800 V (circular) and 1200-1800 V (linear) with a pulse width of 5 µs.
O
Outcome
Composite primary effectiveness endpoint defined as freedom from atrial tachyarrhythmia recurrence, device failure, multiple ablations during the blanking period, or antiarrhythmic drug failure during the evaluation period at 12 months; and primary safety endpoint of major adverse events (MAEs) related to devices or procedures within 3 months.composite

A novel PFA system utilizing both circular and linear contact force-sensing catheters demonstrated high efficacy and safety for pulmonary vein isolation and non-PV trigger ablation in paroxysmal atrial fibrillation.

Limitations

  • Lack of control arm limits direct comparison with other treatment modalities.
  • Generalizability may be limited to Asian populations due to study being conducted exclusively in China.
  • Lacks a control arm
  • Conducted exclusively in an Asian population
  • Restricted to patients with PAF and largely preserved cardiac structure and function
  • Did not include continuous, implantable, or transtelephonic monitoring

Abstract

Pulsed field ablation (PFA) is an emerging innovative technology for treating paroxysmal atrial fibrillation (PAF), featured by its superior speed, accuracy, and reduced risk to adjacent tissues. The NOVA-AF study aimed to evaluate the efficacy and safety of a novel PFA system equipped with two PFA catheters: a circular PFA catheter and a linear PFA catheter integrating contact force-sensing capability, in patients with symptomatic PAF. This prospective, multicenter, single-arm study enrolled 161 patients with symptomatic PAF from seven medical centers in China. The composite primary effectiveness endpoint was defined as freedom from atrial tachyarrhythmia recurrence, device failure, multiple ablations during the blanking period, or antiarrhythmic drug failure during the evaluation period. The primary safety endpoint was the incidence of major adverse events (MAEs) related to the devices or procedures within three months of the procedure. All the ablated lesions (100%) were acutely electrically isolated. No patients underwent repeat ablation during the 90-day blanking period. The 12-month Kaplan–Meier estimates for primary effectiveness success and clinical success (absence of symptomatic atrial fibrillation recurrence) were 83.0% (95% confidence interval, 76.2%–88.0%) and 94.9%, respectively. No MAEs occurred. This novel PFA system is effective and safe for the ablation treatment of patients with symptomatic PAF. Chinese Clinical Trial Registry ( www.chictr.org.cn ), TRN: ChiCTR2400091941, Registration date: Nov 6 2024 (retrospectively registered).

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Cite This Study

Liu et al. (2026) studied Paroxysmal Atrial Fibrillation (n=161). Pulsed Field Ablation System vs. null was evaluated on Composite primary effectiveness endpoint defined as freedom from atrial tachyarrhythmia recurrence, device failure, multiple ablations during the blanking period, or antiarrhythmic drug failure during the evaluation period. (95% CI 76.2-88.0). Pulsed field ablation achieved a 12-month primary effectiveness success rate of 83.0% with zero major adverse events recorded.

synapsesocial.com/papers/69b4fc44b39f7826a300d059https://doi.org/10.1007/s10840-026-02284-z
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  4. 4Efficacy and safety of a novel hexaspline pulsed field ablation system in patients with paroxysmal atrial fibrillation: the PLEASE-AF study2024 · 20 citations
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