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June 27, 2026EP EuropaceOpen Access

PFA achieves comparable short-term atrial remodeling to cryoablation in AF.

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Why the study?

Does pulsed field ablation compared to cryoablation affect short-term biatrial structural and functional remodeling in patients with atrial fibrillation?

Population

30 patients with atrial fibrillation undergoing pulmonary vein isolation at a single center. Excluded: prior…

Comparison

Pulsed field ablation using a pentaspline… vs Cryoablation under fluoroscopy guidance (n=17)

Design

Cohort

Follow-up

3-6 months

Key result

Pulsed field ablation and cryoablation achieved comparable short-term atrial remodeling in patients with atrial fibrillation, with no significant differences in right or left atrial parameters.

Authors

MRM S RiadAEA ElshallMOM Osman

Discussion

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Overview

No significant atrial parameter differences after PFA; leaves open differential remodeling effects in randomized trials.

Key Points

  • This research aims to compare the effects of pulsed field ablation and cryoablation on atrial function and volume in atrial fibrillation patients.
  • Comparative cohort study involving 30 atrial fibrillation patients undergoing either PFA (n=13) or cryoablation (n=17).
  • Both interventions were performed under fluoroscopy with follow-up cardiac magnetic resonance imaging 3-6 months post-ablation.
  • Statistical analyses including ANCOVA were used to assess the changes in atrial volumetric and functional parameters.
  • Both PFA and cryoablation groups showed significant reductions in left atrial expansion index and strain parameters.
  • Right atrial contractile ejection fraction improved markedly post-ablation.
  • No significant differences were found in atrial parameters between PFA and cryoablation groups.

Study Design

Type

Cohort (n=30)

Multicenter

No

Structured PICO

Does pulsed field ablation compared to cryoablation affect short-term biatrial structural and functional remodeling in patients with atrial fibrillation?

P
Population
30 patients with atrial fibrillation undergoing pulmonary vein isolation, excluding those with prior ablation or significant structural heart disease, followed with CMR at 3-6 months.
E
Exposure
Pulsed field ablation (PFA) using a pentaspline catheter under fluoroscopy guidance (n=13)
C
Comparator
Cryoablation under fluoroscopy guidance (n=17)
O
Outcome
Changes in right and left atrial volumes and functions (reservoir, conduit, and contractile strain parameters) measured by cardiac magnetic resonance imaging (CMR) at 3-6 months post-ablationsurrogate

Pulsed field ablation and cryoablation for atrial fibrillation demonstrate comparable short-term biatrial remodeling on CMR, characterized by enhanced right atrial contractility and declined left atrial functional parameters.

Limitations

  • Small sample size
  • Non-randomized design
  • Baseline differences between groups (more persistent AF and larger ventricular volumes in PFA group)

Cite This Study

Riad et al. (2026) conducted a cohort in Atrial fibrillation (n=30). Pulsed field ablation vs. Cryoablation was evaluated on Changes in right and left atrial volumes and functions by cardiac magnetic resonance imaging. Pulsed field ablation and cryoablation achieved comparable short-term atrial remodeling in patients with atrial fibrillation, with no significant differences in right or left atrial parameters.

synapsesocial.com/papers/6a3f97ce125782b61d86599ahttps://doi.org/10.1093/europace/euag105.559
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