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February 28, 2026HeartRhythm Case Reports1 citationsOpen Access

Endothelial disruption: A new complication during pulsed field ablation using a pentaspline catheter

JWJi Mei May WongLankenau Medical CenterAKAli R. KeramatiLankenau Medical CenterBSBruce D. SkolnickValley Health System

Key Result

Pulsed field ablation using a pentaspline catheter can cause left atrial endothelial disruption, a potentially underdetected complication visible via intracardiac echocardiography.

Study Design

Type

Case Report (n=2)

Multicenter

No

Structured PICO

Does pulsed field ablation using a pentaspline catheter cause endothelial disruption in patients with atrial fibrillation?

P
Population
2 male patients (ages 62 and 70) with atrial fibrillation (one persistent, one paroxysmal) undergoing catheter ablation.
I
Intervention
Pulsed field ablation (PFA) using a 31 mm pentaspline catheter (FARAPULSE system, Boston Scientific) with intracardiac echocardiography (ICE) guidance from the left atrium.
O
Outcome
Endothelial disruption detected by intracardiac echocardiography during the procedure.safety

Endothelial disruption is a newly recognized, potentially thrombogenic complication of pulsed field ablation that can be detected using intracardiac echocardiography positioned in the left atrium.

Limitations

  • Small sample size
  • Lack of histologic confirmation
  • Absence of a brain MRI to screen for subclinical cerebrovascular events
  • small sample size
  • lack of histologic confirmation
  • absence of a brain MRI to screen for subclinical cerebrovascular events
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Cite This Study

Wong et al. (2026) conducted a case report in Atrial fibrillation (n=2). Pulsed field ablation (FARAPULSE system) was evaluated on Endothelial disruption. Pulsed field ablation using a pentaspline catheter can cause left atrial endothelial disruption, a potentially underdetected complication visible via intracardiac echocardiography.

synapsesocial.com/papers/6a025a8d9cddff7633412d58https://doi.org/10.1016/j.hrcr.2026.01.019
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Membrane Electroporation and Electropermeabilization: Mechanisms and Models2019 · 795 citations
  2. 2Coronary Spasm During Pulsed Field Ablation of the Mitral Isthmus Line2021 · 116 citations
  3. 3Coronary Arterial Spasm During Pulsed Field Ablation to Treat Atrial Fibrillation2022 · 279 citations
  4. 4Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study2024 · 468 citations
  5. 5State-of-the-art pulsed field ablation for cardiac arrhythmias: ongoing evolution and future perspective2024 · 230 citations