Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicenter study with matched external comparison

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Persistent atrial fibrillation (n=139). Intervention: Algorithm-guided personalized pulsed field ablation (PVI + ablation of algorithm-identified regions) vs. Pulmonary vein isolation plus posterior wall isolation using pulsed field ablation. Primary outcome: Freedom from any atrial arrhythmia (>30 s) at 12 months after a single procedure, without a blanking period (p=0.02).

Q: What does this research mean for the field?

Algorithm-guided personalized pulsed field ablation was evaluated for persistent atrial fibrillation in a prospective multicenter study with a matched external comparison. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Frédéric Anselme; Decebal Gabriel Lațcu; Théo Méral; Arnaud Savouré; Serge Bovéda; Pascal Defaye; Sandrine Venier; Grégoire Massoullié; Pierre Ollitrault; Olivier Thomas; Raphaël Al Hamoud; Maria-Alexandra Nicola; Corentin Chaumont

doi:10.1093/europace/euag225

August 28, 2026EP EuropaceOpen Access

Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicenter study with matched external comparison

View Full Paper

Ask AI

Bookmark

Share

Key result

Personalized algorithm-guided PFA linked to higher 1-year arrhythmia freedom vs systematic anatomical ablation.

P=0.02
n=139

Figures

Why the study?

Recurrence rates after pulmonary vein isolation in persistent atrial fibrillation remain high and additional ablation strategies are debated and heterogeneously applied.

Does algorithm-guided personalized pulsed field ablation improve 1-year freedom from atrial arrhythmia in patients with persistent atrial fibrillation compared to PVI plus posterior wall isolation?

Study Design

Type

Cohort (n=139)

Multicenter

Yes

Structured PICO

Does algorithm-guided personalized pulsed field ablation improve 1-year freedom from atrial arrhythmia in patients with persistent atrial fibrillation compared to PVI plus posterior wall isolation?

P

Population

139 patients (50 prospective, 89 matched external controls) with persistent atrial fibrillation undergoing first-time ablation, followed for a median of 419 days.

I

Intervention

Algorithm-guided personalized pulsed field ablation (PFA) combining pulmonary vein isolation (PVI) and ablation of algorithm-identified putative AF-sustaining regions using a pentaspline PFA catheter (Farawave 31 mm).

C

Comparator

Propensity score-matched external cohort from the France PFA registry (matched for age, sex, AF type, LA dilation, rhythm at onset, CHA2DS2-VASc) who underwent PVI plus posterior wall isolation (PWI) using the pentaspline PFA catheter alone.

O

Outcome

Freedom from any atrial arrhythmia (>30 s) at 12 months after a single procedure, without a blanking period.

Main Result

p-value: p=0.02

Limitations

Modest sample size
Absence of right atrial mapping
Rhythm-monitoring protocol relying on intermittent ECG and Holter that may underestimate asymptomatic recurrence
Non-randomized design and likely residual confounding (operator experience, centre effect, procedural workflow)
Outcomes cannot be attributed to the algorithm alone as it evaluates a combined procedural strategy
modest sample size
absence of right atrial mapping
rhythm-monitoring protocol relying on intermittent ECG and Holter that may underestimate asymptomatic recurrence
non-randomized design
likely residual confounding (operator experience, centre effect, procedural workflow)

Implication

In patients with persistent AF, an algorithm-guided personalized PFA strategy targeting putative AF-sustaining regions improved 1-year arrhythmia-free survival compared to a systematic anatomical PVI plus PWI approach.

Abstract

No abstract yet. The journal hasn't published one we can show.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Anselme et al. (2026) conducted a cohort in Persistent atrial fibrillation (n=139). Algorithm-guided personalized pulsed field ablation (PVI + ablation of algorithm-identified regions) vs. Pulmonary vein isolation plus posterior wall isolation using pulsed field ablation was evaluated on Freedom from any atrial arrhythmia (>30 s) at 12 months after a single procedure, without a blanking period (p=0.02). An algorithm-guided personalized pulsed field ablation strategy was associated with significantly higher 1-year freedom from atrial arrhythmia compared to a systematic anatomical approach (P=0.02).

synapsesocial.com/papers/6a93f0ce6c1a8fb52e79d46b https://doi.org/10.1093/europace/euag225

View Full Paper

Ask AI

Bookmark

Share

Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicenter study with matched external comparison

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Algorithm-guided personalized pulsed field ablation for persistent atrial fibrillation: a prospective multicenter study with matched external comparison

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

More related papers

More from EP Europace

Keep reading

More related papers

More from EP Europace