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September 8, 2026Journal of Clinical MedicineOpen Access

Atrial Fibrillation Ablation Technology Adoption and Procedural Metrics: An 11-Year Longitudinal Service Evaluation at a UK Tertiary Centre

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Why the study?

How rapid changes in AF ablation platforms translate into longitudinal patterns of technology use and procedural characteristics in routine electrophysiology services was less well described.

Population

2862 AF ablation procedures at a UK tertiary center

Comparison

Radiofrequency ablation vs cryoballoon vs pulsed field ablation over time

Design

Retrospective, procedure-level longitudinal service evaluation

Key result

Over 11 years, AF ablation practice shifted toward newer technologies, accompanied by reductions in median procedure time (205 to 104 min) and fluoroscopy time (32 to 13 min).

Authors

IAIbrahim AntounAAAhmed AbdelrazikTSThet Su Su

Discussion

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Overview

Efficiency gains with newer AF ablation technologies may aid workflow and radiation safety; leaves open causal effects on outcomes and generalizability.

Key Points

  • To evaluate longitudinal patterns of ablation technology adoption and operational procedural metrics over an 11-year period in routine clinical practice for atrial fibrillation.
  • Retrospective, single-center longitudinal service evaluation of 2862 atrial fibrillation ablation procedures (index and repeat) performed between April 2014 and June 2025 at a UK tertiary center.
  • Evaluated annual utilization of radiofrequency ablation, cryoballoon, and pulsed field ablation alongside operational metrics: skin-to-skin time, fluoroscopy duration, and dose-area product.
  • Overall, 2862 procedures comprised 1878 (66%) radiofrequency ablations, 735 (26%) cryoballoon ablations, and 249 (9%) pulsed field ablations, with pulsed field ablation rising from 56 cases in 2023 to 95 in the first half of 2025.
  • Median skin-to-skin procedure time decreased from 205 minutes in 2014 to 104 minutes in 2025.
  • Median fluoroscopy duration declined from 32 to 13 minutes, while median radiation dose-area product dropped from 3405 to 782 Gy·cm² over the evaluation period.

Study Design

Type

Observational (n=2,862)

Multicenter

No

Structured PICO

P
Population
2,862 index and repeat atrial fibrillation ablation procedures performed over 11 years at a UK tertiary center.
E
Exposure
Atrial fibrillation ablation technologies (radiofrequency ablation, cryoballoon, pulsed field ablation) over an 11-year period.
O
Outcome
Annual technology use, observed skin-to-skin procedure time, fluoroscopy time, and dose-area product (DAP).

Over an 11-year period at a UK tertiary center, the progressive adoption of newer AF ablation technologies was associated with substantial reductions in procedure duration and radiation exposure.

Limitations

  • Operational measures, not surrogate clinical endpoints
  • No adjusted comparative analysis because technology choice was coupled with calendar era and relevant clinical and operator-level covariates were incomplete
  • Observations should not be interpreted as evidence that any individual ablation modality caused the observed changes or improved clinical outcomes
  • No adjusted comparative analysis performed
  • Technology choice was coupled with calendar era
  • Relevant clinical and operator-level covariates were incomplete
  • Cannot prove individual modalities caused the observed changes or improved clinical outcomes

Cite This Study

Antoun et al. (2026) conducted an observational in Atrial Fibrillation (n=2,862). AF ablation technologies (radiofrequency, cryoballoon, pulsed field ablation) was evaluated on Annual technology use, skin-to-skin procedure time, fluoroscopy time, and dose-area product (DAP). Over 11 years, AF ablation practice shifted toward newer technologies, accompanied by reductions in median procedure time (205 to 104 min) and fluoroscopy time (32 to 13 min).

synapsesocial.com/papers/6a9fd7d558e84d0ff5b46f1bhttps://doi.org/10.3390/jcm15176894
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Also Consider

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

  1. 1Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation2016 · 1,954 citations
  2. 2Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge2020 · 1,481 citations
  3. 3A randomized controlled trial of pulsed field ablation versus standard-of-care ablation for paroxysmal atrial fibrillation: The ADVENT trial rationale and design2023 · 43 citations
  4. 4Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation2023 · 931 citations
  5. 5Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial2023 · 599 citations