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June 27, 2026EP EuropaceOpen Access

PFA performs comparably to CBA on left atrial function and stiffness at three months.

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Why the study?

Does pulsed field ablation preserve left atrial function and stiffness compared to cryoballoon ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation?

Population

36 patients undergoing first-time pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF).

Comparison

Pulsed field ablation for pulmonary vein… vs Cryoballoon ablation for pulmonary vein isolation.

Design

Cohort

Follow-up

3 months

Key result

Pulsed field ablation had comparable effects to cryoballoon ablation on left atrial function and stiffness at 3 months, with non-significant trends favoring PFA for LAEF (p=0.11) and LASi (p=0.13).

Authors

AKA E KaranikolaDTD TsiachrisMKM Kouremeti

Discussion

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Overview

Non-significant trend favors PFA for LA function preservation over CBA; leaves open differential effects pending larger studies.

Key Points

  • This study aims to compare the effects of pulsed field ablation and cryoballoon ablation on left atrial function and stiffness in patients with paroxysmal atrial fibrillation.
  • Prospective, single-center study including patients undergoing first-time pulmonary vein isolation for paroxysmal atrial fibrillation.
  • Echocardiography performed at baseline and three months post-ablation to assess left atrial function and stiffness parameters.
  • Comparison of absolute changes in left atrial function between the cryoballoon and pulsed field ablation groups using the Mann–Whitney U test.
  • No significant differences in left atrial function and stiffness parameters between the CBA and PFA groups at three months (p > 0.05).
  • A non-significant trend indicated a greater reduction in left atrial ejection fraction and an increase in left atrial stiffness in the cryoballoon group compared to pulsed field (p = 0.11 and p = 0.13, respectively).
  • Pulsed field ablation shows a comparable and potentially more favorable effect on left atrial function during the blanking period.

Study Design

Type

Cohort (n=36)

Multicenter

No

Structured PICO

Does pulsed field ablation preserve left atrial function and stiffness compared to cryoballoon ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation?

P
Population
36 patients undergoing first-time pulmonary vein isolation for paroxysmal atrial fibrillation, evaluated at baseline and three months post-procedure.
E
Exposure
Pulsed field ablation (PFA) for pulmonary vein isolation.
C
Comparator
Cryoballoon ablation (CBA) for pulmonary vein isolation.
O
Outcome
Absolute changes in echocardiographic indices of left atrial (LA) function (LAEF, LASr, LAScd, LASct) and LA stiffness (LASi) at three months post-procedure.surrogate

Pulsed field ablation demonstrates a comparable and potentially more favorable profile to cryoballoon ablation in preserving left atrial function and stiffness at three months post-ablation.

Limitations

  • Single-center design
  • Small sample size requiring larger multicenter validation
  • Short-term follow-up limited to the blanking period
  • small sample size
  • single-center study

Cite This Study

Karanikola et al. (2026) conducted a cohort in Paroxysmal atrial fibrillation (n=36). Pulsed field ablation vs. Cryoballoon ablation was evaluated on Absolute changes in echocardiographic indices of left atrial function and stiffness at three months. Pulsed field ablation had comparable effects to cryoballoon ablation on left atrial function and stiffness at 3 months, with non-significant trends favoring PFA for LAEF (p=0.11) and LASi (p=0.13).

synapsesocial.com/papers/6a3f97ce125782b61d865a44https://doi.org/10.1093/europace/euag105.462
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