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June 27, 2026EP EuropaceOpen Access

Focal lattice-tip catheter linked to ~64% persistent LAA isolation, far exceeding pentaspline PFA.

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Why the study?

Does ablation with a focal lattice-tip dual energy catheter improve persistent isolation of extra-pulmonary areas compared to a single shot pentaspline PFA catheter in non-paroxysmal AF patients undergoing redo ablation?

Population

297 consecutive non-paroxysmal atrial fibrillation patients undergoing redo ablation procedure, 54.2% male.

Comparison

Ablation with a focal lattice-tip dual energy… vs Ablation with a single shot pentaspline PFA…

Design

Cohort

Follow-up

98±24 days

Key result

A focal lattice-tip dual-energy catheter yielded higher persistent LAA isolation (63.5% vs 0.9%), MI block (52.2% vs 1.7%), and CS isolation (45% vs 1.7%) than a pentaspline PFA catheter.

Authors

VFV M La FaziaMMM MarinoECE Chiarazzo

Discussion

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Overview

Low persistent LAA isolation with lattice-tip PFA warrants clinical caution; leaves open durability questions for randomized trials.

Key Points

  • This study aims to compare the efficacy of a single-shot pentaspline pulsed field ablation catheter with a dual energy catheter in isolating extrapulmonary areas during ablation procedures.
  • Prospective analysis of data from non-paroxysmal AF patients undergoing redo ablation between November 2024 and September 2025.
  • Isolation procedures included left atrial appendage, coronary sinus, and mitral isthmus using two different pulsed field ablation catheters.
  • Evaluation of persistent isolation rates was conducted at 98±24 days post-procedure.
  • Persistent isolation of the left atrial appendage was found in 63.5% of patients using the dual energy catheter versus 0.9% for the pentaspline catheter.
  • Mitral isthmus block was achieved in 52.2% of the lattice-tip catheter group compared to 1.7% of the pentaspline group.
  • Coronary sinus isolation was successful in 45% with the dual energy catheter versus 1.7% with the pentaspline catheter.

Study Design

Type

Cohort (n=297)

Structured PICO

Does ablation with a focal lattice-tip dual energy catheter improve persistent isolation of extra-pulmonary areas compared to a single shot pentaspline PFA catheter in non-paroxysmal AF patients undergoing redo ablation?

P
Population
297 patients with non-paroxysmal atrial fibrillation undergoing repeat ablation, followed up at 98 days for remapping.
E
Exposure
Ablation with a focal lattice-tip dual energy catheter (using pulsed field ablation [PFA] only [n=78] or a combination of PFA and radiofrequency [n=104]).
C
Comparator
Ablation with a single shot pentaspline PFA catheter (n=115).
O
Outcome
Persistent isolation of extra-pulmonary areas (LAA isolation, MI block, and CS isolation) at remapping at 98±24 days.surrogate

Main Result

Absolute Event Rate: 63.5% vs 0.9%

A focal lattice-tip dual-energy catheter significantly improves the incidence of persistent isolation in extra-pulmonary areas compared to a single-shot pentaspline PFA catheter in patients undergoing redo AF ablation.

Cite This Study

Fazia et al. (2026) conducted a cohort in Non-paroxysmal atrial fibrillation (n=297). Focal lattice-tip dual energy catheter vs. Single shot pentaspline PFA catheter was evaluated on Persistent isolation of left atrial appendage (LAA) at remapping. A focal lattice-tip dual-energy catheter yielded higher persistent LAA isolation (63.5% vs 0.9%), MI block (52.2% vs 1.7%), and CS isolation (45% vs 1.7%) than a pentaspline PFA catheter.

synapsesocial.com/papers/6a3f97e8125782b61d865a69https://doi.org/10.1093/europace/euag105.578
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Also Consider

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

  1. 1Pulsed field ablation of the coronary sinus and mitral isthmus with the lattice-tip catheter: promising acute results, uncertain durability2026
  2. 2Feasibility and Safety of Pulsed Field Ablation for Coronary Sinus and Left Atrial Appendage Isolation and Mitral Isthmus Ablation: Acute and Chronic Findings2025 · 33 citations
  3. 3Circumferential versus focal superior vena cava ablation using the lattice tip catheter: insights from a multicenter experience2026
  4. 4Anatomical ablation using a dual-energy contact force-sensing focal ablation catheter vs standard radiofrequency ablation catheter for persistent atrial fibrillation: a comparative prospective study2026
  5. 5Acute Efficacy of Pulsed‐Field Ablation of the Mitral Isthmus Using a Pentaspline Catheter and Two Different Ablation Settings2025