Comparison of Effects of Pulsed Field Ablation and Cryoablation on Left Atrial Stiffness Using Invasively Derived Pressure–Volume Relationship

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Atrial fibrillation undergoing first-time pulmonary vein isolation (n=38). Intervention: Pulsed field ablation (Farapulse system) vs. Cryoballoon ablation (POLARx system). Primary outcome: Change in passive elastic chamber stiffness constant (Δα, in mL⁻¹) immediately pre- vs. post-procedurally (p=0.29).

Q: What does this research mean for the field?

Pulsed field ablation and cryoballoon ablation demonstrate comparable acute effects on passive left atrial compliance and chamber stiffness during pulmonary vein isolation. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Christos Konstantinos Antoniou; Dimitris Tsiachris; Aikaterini-Eleftheria Karanikola; Michail Botis; Athanasios Kordalis; Ioannis Doundoulakis; Panagiotis Xydis; Dimitrios Klettas; Christina A. Chrysohoou; Konstantinos P. Tsioufis

doi:10.1002/joa3.70520

November 5, 2026Journal of ArrhythmiaOpen Access

Comparison of Effects of Pulsed Field Ablation and Cryoablation on Left Atrial Stiffness Using Invasively Derived Pressure–Volume Relationship

View Full Paper

Ask AI

Bookmark

Share

Key result

Pulsed field ablation shows comparable acute left atrial stiffness changes to cryoballoon ablation.

P=0.29
n=38

Why the study?

The acute effects of pulsed field ablation on passive left atrial mechanical properties had not previously been assessed by reconstructing pressure-volume relationships from invasive intracavitary pressure measurements.

Does pulsed field ablation compared to cryoballoon ablation affect acute left atrial passive stiffness and mechanical properties in patients undergoing first-time pulmonary vein isolation for atrial fibrillation?

Key Points

To assess and compare the acute effects of pulsed field ablation and cryoballoon ablation on left atrial passive mechanical properties using invasive pressure–volume measurements.
In a nonrandomized cohort of 38 first-time atrial fibrillation patients undergoing pulmonary vein isolation, patients were treated with either pulsed field ablation (PFA) or cryoballoon ablation (CBA).
Left atrial pressure was invasively measured immediately pre- and post-procedure, and volume was derived echocardiographically to calculate the elastic constant (b) and passive elastic chamber stiffness constant (α).
Passive elastic chamber stiffness constant (α) did not significantly change pre- to post-procedure in either the CBA group (p = 0.204) or the PFA group (p = 0.210), with no significant difference between groups (p = 0.29).
The elastic constant (b) decreased significantly post-procedure in the CBA group (median difference -6.38 × 10⁻², p = 0.034) but showed no significant change in the PFA group (p = 0.709), with no significant difference between groups (p = 0.11).
No significant associations were observed between changes in stiffness constants (Δα, Δb) and baseline left atrial volume (p = 0.195 and p = 0.227) or atrial fibrillation duration.

Study Design

Type

Cohort (n=38)

Randomization

Nonrandomized

Structured PICO

Does pulsed field ablation compared to cryoballoon ablation affect acute left atrial passive stiffness and mechanical properties in patients undergoing first-time pulmonary vein isolation for atrial fibrillation?

P

Population

38 patients with atrial fibrillation (median age 62.5 in CBA, 66.0 in PFA; 42.1% female) undergoing first-time pulmonary vein isolation, evaluated acutely pre- and post-procedurally and at 3 months.

I

Intervention

Pulsed field ablation (PFA) for pulmonary vein isolation using the Farapulse system (n=20)

C

Comparator

Cryoballoon ablation (CBA) for pulmonary vein isolation using the POLARx Cryoballoon system (n=18)

O

Outcome

Acute change in left atrial passive mechanical properties—specifically the passive elastic chamber stiffness constant (α, in mL⁻¹) and the left atrial elastic constant (b, in mmHg)—derived from invasive intracavitary pressure measurements and echocardiographic volumes immediately pre- and post-procedurallysurrogate

Main Result

Absolute Event Rate: 0.00286% vs 0.0132%

p-value: p=0.29

Both pulsed field ablation and cryoballoon ablation preserve acute passive left atrial compliance without increasing the passive chamber stiffness constant immediately after first-time pulmonary vein isolation.

Limitations

Small, nonrandomized sample size limits robustness and precludes definitive between-group comparisons
Cardiac magnetic resonance imaging was not used to assess and correlate chronic fibrosis with acute mechanical changes
Lack of invasive reassessment at follow-up due to logistical and ethical considerations
Small, nonrandomized sample size limits robustness of comparisons
Magnetic resonance imaging was not used to assess and correlate chronic fibrosis with acute mechanical changes
No invasive pressure-volume reassessment during chronic follow-up

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Comparable acute LA compliance preservation with either technique may support similar short-term safety; leaves open differential long-term effects in randomized trials.

Abstract

Background Acute effects of pulsed field ablation (PFA) on passive atrial mechanical properties have not hitherto been assessed by reconstruction of pressure–volume relationship using invasive intracavitary pressure measurements. Methods In a cohort of 38 first‐time atrial fibrillation ablation patients, submitted to pulmonary vein isolation, we studied the effects of PFA and cryoballoon ablation on the left atrial elastic constant and passive elastic chamber stiffness constant, expressing baseline left atrial conditions and quantifying passive left atrial stiffness, respectively. Left atrial pressure was invasively measured immediately pre‐ and post‐procedurally, while volume values were obtained echocardiographically. Results No differences were noted in passive elastic chamber stiffness constant values, pre‐ and post‐procedurally in either group. No differences were noted between CBA and PFA groups. There were no observable associations between Δ α and Δ b and either AF duration or preprocedural left atrial volume. Conclusions Based on the above, CBA and PFA demonstrated comparable effects on left atrial mechanical properties in the acute post‐ablation setting.

Discussion

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

Cite This Study

Antoniou et al. (2026) conducted a cohort in Atrial fibrillation undergoing first-time pulmonary vein isolation (n=38). Pulsed field ablation (Farapulse system) vs. Cryoballoon ablation (POLARx system) was evaluated on Change in passive elastic chamber stiffness constant (Δα, in mL⁻¹) immediately pre- vs. post-procedurally (p=0.29). Pulsed field ablation and cryoballoon ablation demonstrated comparable acute effects on passive left atrial stiffness (Δα 0.286×10⁻² vs. 1.32×10⁻² mL⁻¹, p=0.29).

synapsesocial.com/papers/6aee6bd871a7594806220c7e https://doi.org/10.1002/joa3.70520

View Full Paper

Ask AI

Bookmark

Share

Comparison of Effects of Pulsed Field Ablation and Cryoablation on Left Atrial Stiffness Using Invasively Derived Pressure–Volume Relationship

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Comparison of Effects of Pulsed Field Ablation and Cryoablation on Left Atrial Stiffness Using Invasively Derived Pressure–Volume Relationship

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading