Key result
PFA for persistent AF is linked to zero arrhythmia burden in ~61% of patients.
Why the study?
Intermittent monitoring may overestimate the effectiveness of PFA in PeAF, prompting investigation of PFA feasibility with continuous follow-up using insertable cardiac monitoring.
Does pulsed field ablation effectively reduce atrial arrhythmia burden in patients with persistent atrial fibrillation when assessed by continuous monitoring?
Cohort (n=49)
Does pulsed field ablation effectively reduce atrial arrhythmia burden in patients with persistent atrial fibrillation when assessed by continuous monitoring?
Pulsed field ablation demonstrates effectiveness in treating persistent atrial fibrillation, with over 60% of patients showing zero atrial arrhythmia burden at 14 months when rigorously assessed via continuous insertable cardiac monitoring.
May support PFA in persistent AF with continuous monitoring; leaves open need for RCTs.
Most studies have followed patients with persistent atrial fibrillation (PeAF) using 12-lead or 24-h Holter electrocardiography, but this may overestimate the effectiveness of pulsed field ablation (PFA) in the treatment of PeAF. This study aimed to investigate the feasibility of PFA in patients with PeAF and follow-up using insertable cardiac monitoring that can provide information on the actual status of atrial arrhythmia (AA) recurrence after PFA. We prospectively enrolled 49 patients with PeAF who underwent PFA strategy comprising superior vena cava isolation, pulmonary vein isolation, and posterior wall box isolation between December 2022 and January 2024. After median follow-up of 14.1 months, 30 patients (61.22%) had zero AA burden. Kaplan-Meier analysis show that the freedom from recurrence increased with arrhythmia duration thresholds, from 59.54% to 80.50% (duration < 2 min vs. duration > 48 h, p = 0.040). Safety events occurred in two patients (one transient ischemic attack and one pseudoaneurysm). PFA is an effective modality for the treatment of patients with PeAF.
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Li et al. (2025) conducted a cohort in Persistent atrial fibrillation (n=49). Pulsed field ablation (PFA) was evaluated on Zero atrial arrhythmia (AA) burden. Pulsed field ablation for persistent atrial fibrillation resulted in 61.22% of patients having zero atrial arrhythmia burden at a median follow-up of 14.1 months.
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