Pulsed-field ablation versus single-catheter high-power short-duration radiofrequency ablation for atrial fibrillation: Procedural characteristics, myocardial injury, and mid-term outcomes

Pulsed-field ablation (PFA) has emerged as a novel treatment strategy for patients with atrial fibrillation (AF). First studies report favorable procedural data as well as promising data on lesion durability in terms of durable pulmonary vein isolation (PVI), 1 Reddy V.Y. Neuzil P. Koruth J.S. et al. Pulsed field ablation for pulmonary vein isolation in atrial fibrillation. J Am Coll Cardiol. 2019; 74: 315-526 Crossref PubMed Scopus (293) Google Scholar ,2 Reddy V.Y. Dukkipati S.R. Neuzil P. et al. Pulsed field ablation of paroxysmal atrial fibrillation: 1-year outcomes of IMPULSE, PEFCAT, and PEFCAT II. JACC Clin Electrophysiol. 2021; 7: 614-627 Crossref PubMed Scopus (154) Google Scholar challenging the current thermal energy source of radiofrequency (RF) or cryotherapy. A direct comparison using a single-shot device (PFA) vs a high-power short-duration (HPSD) protocol employing a single RF catheter for AF ablation is lacking. Thus, our aim was to compare PVI using PFA (PFA group) with single-catheter HPSD-RF ablation (S-HPSD-RF group) regarding efficiency, safety, myocardial injury, and mid-term outcomes.