January 18, 2026

Short‐Term Procedural Outcomes of Posterior Wall Isolation Using the Affera Pulse Field Ablation System

UTUdit Thakur JJJasper JunkerThe Royal Melbourne Hospital YKYoulin KohThe Royal Melbourne Hospital

Key Result

Posterior wall isolation using the Affera Sphere‐9 system achieved 100% acute success, with a 97.5% first-pass isolation rate in 40 patients.

Key Points

To evaluate the procedural outcomes of posterior wall isolation using the Affera Pulse Field Ablation System.
Retrospective analysis of consecutive patients undergoing posterior wall isolation with Affera Sphere‐9.
Assessment of baseline characteristics and procedural data including PWI time and number of lesions.
Determination of acute PWI success as the primary endpoint.
97.5% first pass PWI success achieved; overall acute success was 100%.
Median time to complete PWI was 7.0 minutes (IQR 5.1–11.0).
Mean number of lesions created was 19.6 ± 6.6.
Two minor vascular complications recorded (5.0%), managed conservatively.
95% of patients remained free from atrial arrhythmia after a median follow-up of 76 days.

Structured PICO

Does posterior wall isolation using the Affera Sphere-9 pulsed field ablation system achieve high acute procedural success in patients with atrial fibrillation?

Population

40 patients with atrial fibrillation (13 paroxysmal [32.5%], 27 persistent [67.5%]) undergoing posterior wall isolation

Intervention

Posterior wall isolation (PWI) using the Affera Sphere-9 lattice-tip pulsed field ablation (PFA) catheter

Outcome

Acute PWI successsurrogate

The Affera Sphere-9 pulsed field ablation system provides highly effective and rapid acute posterior wall isolation in patients with atrial fibrillation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

ABSTRACT Background Posterior wall isolation (PWI) is often added to pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF) and at redo ablation. Still, procedural performance with the Affera pulsed field ablation (PFA) platform is not well described. Methods We retrospectively analyzed consecutive patients who underwent PWI with the Affera Sphere‐9 lattice‐tip catheter from April to August 2025. Baseline characteristics and procedural data, including PWI time, number of lesions, and acute success, were analyzed. The primary procedural endpoint was acute PWI success. Secondary measures included time to PWI, number of applications, posterior wall area isolated, and complications. Results Forty patients underwent PWI (paroxysmal AF 13 32.5%, persistent AF 27 67.5%). First pass PWI was achieved in 97.5%; overall acute PWI success was 100%. Median time to complete PWI was 7.0 min (IQR 5.1–11.0). Mean lesions for PWI were 19.6 ± 6.6, and the mean posterior wall area isolated was 12.9 ± 4.5 cm². Two minor vascular complications occurred (5.0%): one acute and one delayed femoral hematoma, both managed conservatively. After a median follow‐up of 76 58.5–121 days, 38/40 (95%) patients remained free from atrial arrhythmia. Conclusions PWI with the Affera Sphere‐9 system achieved 97.5% first‐pass isolation with rapid, consistent procedural times. Further study of lesion durability and clinical outcomes is warranted.

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