Pulsed-field ablation demonstrates superior pulmonary vein isolation durability at 90 days: Pooled analysis of protocol-mandated remapping data

Successful and durable pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF), with pulmonary vein (PV) reconnection being the predominant mechanism of recurrence.1 Pulsed-field ablation (PFA) is non-inferior to radiofrequency (RFA) or cryoballoon ablation (CBA) in achieving freedom from atrial arrhythmia recurrence at 12 months with comparable safety profile.2 However, relying on clinical efficacy or on electro-anatomical mapping at the time of clinically indicated redo procedures is an imperfect measure of lesion durability, as these outcomes are heavily influenced by inherent selection bias and monitoring strategies.