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June 27, 2026EP EuropaceOpen Access

Pentaspline PFA links to ~97% first-pass PVI success and shorter procedures versus loop catheters.

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Why the study?

Does the use of a pentaspline PFA catheter improve acute procedural characteristics and operator experience compared to variable-loop or fixed-loop circular catheters in patients undergoing first-time PFA for AF?

Population

450 consecutive patients undergoing first-time pulsed field ablation for atrial fibrillation, mean age 64.9…

Comparison

Pulmonary vein isolation with or without… vs Pulmonary vein isolation with or without…

Design

Cohort

Follow-up

peri-procedural

Key result

The pentaspline PFA catheter was associated with higher first-pass PVI rates (97.3% vs 86.0% for variable-loop and 86.9% for fixed-loop; p<0.001) and shorter procedural times.

Authors

LML MarconGVG VettaNMN Marimpouy

Discussion

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Overview

May support PS technology for PVI; leaves open multicenter validation and long-term outcomes.

Key Points

  • To compare the efficacy, safety, and operator experience of three pulsed field ablation technologies for pulmonary vein and posterior wall isolation in atrial fibrillation.
  • Included 450 consecutive patients undergoing first-time pulsed field ablation.
  • Procedures performed by 25 operators across 8 centers, each with at least 20 cases of experience per technology.
  • Operators rated procedural aspects via a 5-point Likert-scale survey.
  • First-pass pulmonary vein isolation rates were highest with the pentaspline catheter (97.3%), significantly different from variable-loop (86.0%) and fixed-loop (86.9%) catheters (p<0.001).
  • Pentaspline catheter procedures had shorter times compared to variable-loop (60 vs. 50 min, p=0.002) and fixed-loop (60 vs. 50 min, p=0.003) for PVI-only cases.
  • All technologies exhibited low rates of major (0.7%) and minor (1.8%) peri-procedural complications.

Study Design

Type

Observational (n=450)

Multicenter

Yes

Structured PICO

Does the use of a pentaspline PFA catheter improve acute procedural characteristics and operator experience compared to variable-loop or fixed-loop circular catheters in patients undergoing first-time PFA for AF?

P
Population
450 consecutive patients (mean age 64.9 years, 46.2% female) undergoing first-time pulsed field ablation for atrial fibrillation.
E
Exposure
Pulmonary vein isolation (PVI) with or without posterior wall isolation (PWI) using a pentaspline (PS) pulsed field ablation catheter
C
Comparator
Pulmonary vein isolation (PVI) with or without posterior wall isolation (PWI) using a variable-loop circular (VL) or fixed-loop circular (FL) pulsed field ablation catheter
O
Outcome
Acute procedural characteristics (first-pass PVI, procedural time, radiation exposure), safety, and operator experience (assessed via 5-point Likert-scale survey)

Main Result

Absolute Event Rate: 97.3% vs 86%

p-value: p=<0.001

Among single-shot PFA systems, the pentaspline catheter was associated with shorter procedural times, higher first-pass PVI rates, and better operator ratings compared to circular catheters, with comparable safety.

Cite This Study

Marcon et al. (2026) conducted an observational in Atrial fibrillation (n=450). Pentaspline (PS) pulsed field ablation catheter vs. Variable-loop circular (VL) and fixed-loop circular (FL) catheters was evaluated on First-pass pulmonary vein isolation (PVI) per patient (p=<0.001). The pentaspline PFA catheter was associated with higher first-pass PVI rates (97.3% vs 86.0% for variable-loop and 86.9% for fixed-loop; p<0.001) and shorter procedural times.

synapsesocial.com/papers/6a3f97e8125782b61d865a72https://doi.org/10.1093/europace/euag105.599
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Also Consider

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

  1. 1Single-center experience of an image-guided single-access, single-catheter pulsed field ablation approach for pulmonary vein isolation2026
  2. 2Novel mapping-integrated pulsed-field ablation technology for pulmonary vein isolation in patients with atrial fibrillation: learning curve, efficiency, and safety2026
  3. 3Prospective evaluation of the acute effectiveness and safety of the circular array pulsed field ablation catheter for atrial fibrillation ablation2026
  4. 4First experiences with PulseSelect PFA ablation system in a Farapulse PFA experienced center2026
  5. 5Pulsed-field ablation using a circular multielectrode catheter for persistent atrial fibrillation: procedural outcomes and lesion durability2026