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June 27, 2026EP EuropaceOpen Access

Pentaspline PFA links to ~97% first-pass PVI success and shorter procedures versus loop catheters.

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Why the study?

Evidence comparing peri-procedural performances and operator experience among the three commercially available pulsed field ablation systems was limited.

Does the use of a pentaspline PFA catheter improve acute procedural characteristics and operator experience compared to variable-loop or fixed-loop circular catheters in patients undergoing first-time PFA for AF?

Population

450 consecutive patients undergoing first-time PFA for AF across 8 centers

Comparison

Pentaspline vs variable-loop circular vs fixed-loop circular PFA catheters for PVI +/- PWI

Design

Multicenter observational study and operator survey

Key result

The pentaspline PFA catheter was associated with higher first-pass PVI rates (97.3% vs 86.0% for variable-loop and 86.9% for fixed-loop; p<0.001) and shorter procedural times.

Authors

LML MarconGVG VettaNMN Marimpouy

Discussion

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Overview

May support PS technology for PVI; leaves open multicenter validation and long-term outcomes.

Key Points

  • To compare the efficacy, safety, and operator experience of three pulsed field ablation technologies for pulmonary vein and posterior wall isolation in atrial fibrillation.
  • Included 450 consecutive patients undergoing first-time pulsed field ablation.
  • Procedures performed by 25 operators across 8 centers, each with at least 20 cases of experience per technology.
  • Operators rated procedural aspects via a 5-point Likert-scale survey.
  • First-pass pulmonary vein isolation rates were highest with the pentaspline catheter (97.3%), significantly different from variable-loop (86.0%) and fixed-loop (86.9%) catheters (p<0.001).
  • Pentaspline catheter procedures had shorter times compared to variable-loop (60 vs. 50 min, p=0.002) and fixed-loop (60 vs. 50 min, p=0.003) for PVI-only cases.
  • All technologies exhibited low rates of major (0.7%) and minor (1.8%) peri-procedural complications.

Study Design

Type

Observational (n=450)

Multicenter

Yes

Structured PICO

Does the use of a pentaspline PFA catheter improve acute procedural characteristics and operator experience compared to variable-loop or fixed-loop circular catheters in patients undergoing first-time PFA for AF?

P
Population
450 consecutive patients (mean age 64.9 years, 46.2% female) undergoing first-time pulsed field ablation for atrial fibrillation.
E
Exposure
Pulmonary vein isolation (PVI) with or without posterior wall isolation (PWI) using a pentaspline (PS) pulsed field ablation catheter
C
Comparator
Pulmonary vein isolation (PVI) with or without posterior wall isolation (PWI) using a variable-loop circular (VL) or fixed-loop circular (FL) pulsed field ablation catheter
O
Outcome
Acute procedural characteristics (first-pass PVI, procedural time, radiation exposure), safety, and operator experience (assessed via 5-point Likert-scale survey)

Main Result

Absolute Event Rate: 97.3% vs 86%

p-value: p=<0.001

Among single-shot PFA systems, the pentaspline catheter was associated with shorter procedural times, higher first-pass PVI rates, and better operator ratings compared to circular catheters, with comparable safety.

Cite This Study

Marcon et al. (2026) conducted an observational in Atrial fibrillation (n=450). Pentaspline (PS) pulsed field ablation catheter vs. Variable-loop circular (VL) and fixed-loop circular (FL) catheters was evaluated on First-pass pulmonary vein isolation (PVI) per patient (p=<0.001). The pentaspline PFA catheter was associated with higher first-pass PVI rates (97.3% vs 86.0% for variable-loop and 86.9% for fixed-loop; p<0.001) and shorter procedural times.

synapsesocial.com/papers/6a3f97e8125782b61d865a72https://doi.org/10.1093/europace/euag105.599
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