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June 27, 2026EP EuropaceOpen Access

Concomitant surgical nsPFA ablation shows safety and achieves persistent PVI in ~80% of high-dose patients.

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Why the study?

Does nanosecond pulsed field ablation (nsPFA) safely and effectively achieve pulmonary vein and posterior wall isolation in atrial fibrillation patients undergoing concomitant cardiac surgery?

Population

43 patients with atrial fibrillation undergoing concomitant cardiac surgery.

Design

Cohort

Follow-up

6 to 12 months

Key result

Concomitant surgical ablation using the nsPFA clamp was safe with no device-related complications and achieved persistent pulmonary vein isolation in 80% of high-dose patients.

Authors

BMB MaesenGDG DunningtonADA Driessen

Discussion

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Overview

Durable PVI rates in this small series support further evaluation; leaves open clinical impact in randomized trials.

Key Points

  • This trial aimed to assess the safety and efficacy of nanosecond pulsed field ablation (nsPFA) in patients with atrial fibrillation during cardiac surgery.
  • Conducted at three centers in the Netherlands with 43 atrial fibrillation patients.
  • Tested two doses of nsPFA applied during surgical ablation to achieve pulmonary vein isolation and posterior wall isolation.
  • Performed electroanatomical mapping and 24-hour Holter monitoring at follow-up intervals of 6 and 12 months.
  • Achieved 100% acute bidirectional block in high dose patients during procedure.
  • At 6-month follow-up, 88% of patients were free from atrial tachyarrhythmia.
  • No serious adverse events or device-related complications were reported.

Structured PICO

Does nanosecond pulsed field ablation (nsPFA) safely and effectively achieve pulmonary vein and posterior wall isolation in atrial fibrillation patients undergoing concomitant cardiac surgery?

P
Population
43 patients with atrial fibrillation undergoing concomitant cardiac surgery, evaluated for safety and efficacy of nsPFA with up to 12 months of follow-up.
I
Intervention
Nanosecond pulsed field ablation (nsPFA) using bipolar surgical ablation clamps to perform posterior wall isolation (PWI) and pulmonary vein isolation (PVI) (tested at low and high doses).
O
Outcome
Rate of acute major adverse events (MAEs) and events within 30 days postoperatively (primary and secondary safety endpoint).safety

This first-in-human feasibility trial demonstrates that nanosecond pulsed field ablation during concomitant cardiac surgery is safe and achieves durable pulmonary vein and posterior wall isolation.

Cite This Study

Maesen et al. (2026) studied Atrial fibrillation (n=43). Nanosecond pulsed field ablation (nsPFA) using bipolar surgical ablation clamps was evaluated on Rate of acute major adverse events (MAEs) and events within 30 days postoperatively. Concomitant surgical ablation using the nsPFA clamp was safe with no device-related complications and achieved persistent pulmonary vein isolation in 80% of high-dose patients.

synapsesocial.com/papers/6a3f97bb125782b61d865916https://doi.org/10.1093/europace/euag105.423
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Anatomical ablation using a dual-energy contact force-sensing focal ablation catheter vs standard radiofrequency ablation catheter for persistent atrial fibrillation: a comparative prospective study2026
  2. 2Pulsed-field ablation using a circular multielectrode catheter for persistent atrial fibrillation: procedural outcomes and lesion durability2026
  3. 3Comparative Study of Nanosecond and Microsecond Pulsed Field Ablation for Pulmonary Vein Isolation in Preclinical Models2025
  4. 4The Clinical Utility of <scp>3D</scp> Electroanatomical Mapping for Atrial Fibrillation Ablation by Pulsed Field Ablation2025 · 1 citations
  5. 5Pulsed field atrial fibrillation ablation with a focal tip dual energy contact force-sensing catheter under local anesthesia: anatomical and clinical correlation2026