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June 27, 2026EP EuropaceOpen Access

Single-access CT-guided PFA for AF achieves 100% acute PVI with rare major complications.

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Why the study?

Does an image-guided, single-access, single-catheter pulsed field ablation approach achieve effective pulmonary vein isolation in patients with atrial fibrillation?

Population

191 consecutive patients undergoing first-time pulmonary vein isolation for atrial fibrillation, mean age…

Design

Cohort

Key result

An integrated CT-guided, single-access, single-catheter pulsed field ablation strategy for atrial fibrillation achieved 100% acute pulmonary vein isolation with rare major complications.

Authors

OAO AlothmanAKA KeelaniHAH Abdelwahab

Discussion

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Overview

Supports feasibility of novel ablation approach; hypothesis-generating, requiring randomized validation before clinical adoption.

Key Points

  • This study aims to evaluate a streamlined approach to pulmonary vein isolation using pulsed field ablation.
  • Retrospective study of 191 patients undergoing first-time pulmonary vein isolation for atrial fibrillation.
  • Single-shot pulsed field ablation strategy with either pentaspline or circular multielectrode catheter.
  • Integration of contrast-enhanced cardiac CT with fluoroscopy for procedural guidance and transseptal access.
  • Achieved acute isolation of all pulmonary veins in 100% of patients.
  • Mean procedure duration was 60 minutes, with fluoroscopy time averaging 6.8 minutes and low radiation exposure.
  • Transient phrenic nerve palsy occurred in 11.5% of patients, with complete recovery in all during the hospital stay.

Study Design

Type

Observational (n=191)

Multicenter

No

Structured PICO

Does an image-guided, single-access, single-catheter pulsed field ablation approach achieve effective pulmonary vein isolation in patients with atrial fibrillation?

P
Population
191 patients (mean age 67 years, 35% female) undergoing first-time pulmonary vein isolation for atrial fibrillation using a single-access pulsed field ablation strategy.
E
Exposure
Image-guided, single-access, single-catheter pulsed field ablation (PFA) strategy using a biphasic, bipolar waveform with either a pentaspline catheter (n=124) or a circular multielectrode catheter (n=67), guided by integrated 3D CT-fluoroscopy.
O
Outcome
Acute isolation of all pulmonary veinssurrogate

A streamlined, single-access, single-catheter pulsed field ablation approach for atrial fibrillation is feasible, achieving 100% acute pulmonary vein isolation with low procedural times and complications.

Cite This Study

Alothman et al. (2026) conducted an observational in Atrial fibrillation (n=191). Integrated CT-guided, single-access, single-catheter pulsed field ablation was evaluated on Acute isolation of all pulmonary veins. An integrated CT-guided, single-access, single-catheter pulsed field ablation strategy for atrial fibrillation achieved 100% acute pulmonary vein isolation with rare major complications.

synapsesocial.com/papers/6a3f9785125782b61d8657afhttps://doi.org/10.1093/europace/euag105.468
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