Dosing of single-shot pulsed field ablation systems: A systematic review of efficacy and safety balance.
Isabelle N Bax, Roos E Bolhuis, Marisa van der Graaf et al.
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In 30 seconds
This systematic review evaluated the efficacy and safety of single-shot pulsed field ablation (PFA) systems for pulmonary vein isolation in atrial fibrillation, analyzing 47 primary studies. The review found that all PFA systems achieved nearly 100% acute pulmonary vein isolation. However, complications such as acute kidney injury and myocardial injury were associated with specific catheter types and increased applications.
Key findings
- All PFA systems reported almost 100% acute pulmonary vein isolation.
- Acute kidney injury occurred with pentaspline (n = 39 of 1307) and variable-loop catheters (n = 4 of 122).
- 6-12 months of arrhythmia-free survival was 55%-88% for multispline and circular catheters, and 77%-88% for spherical catheters.
Why it matters
Understanding the efficacy and safety profile of pulsed field ablation systems is crucial for clinicians managing atrial fibrillation, as it informs treatment decisions and patient counseling regarding potential complications.
What to keep in mind
The review highlights the heterogeneity of PFA systems, making direct comparisons challenging.