What is the incidence of acute residual pulmonary vein connections detected by electroanatomic mapping during pulsed-field ablation of atrial fibrillation?
Approximately 25% of patients exhibit acute residual pulmonary vein connections after standard pulsed-field ablation, suggesting the clinical value of a mandatory post-PFA waiting period to identify reversible electroporation.
Using 3D-EAM, an acute residual connection of at least 1 PV was observed in a quarter of patients after standard PFA delivery and was most common in the left superior PV. Potential mechanisms include reversible electroporation, highlighting the potential need for additional lesions and the value of a mandatory post-PFA "waiting period."
Mills et al. (2025) studied this question.