Journal of Cardiovascular Electrophysiology最新文献

{"title":"Real-World Experience With the Balloon-in-Basket Pulsed Field Ablation System for Pulmonary Vein Isolation and Ablation of Extra-Pulmonary Vein Sites.","authors":"Henri Xhakupi, Tommaso Sattin, Domenico G Della Rocca, Ludovica Carmagnola, Domenico Laviola, Paul-Adrian Calburean, Luca Canovi, Francesca Salghetti, Giampaolo Vetta, Alvise Del Monte, Charles Audiat, Antonio Sorgente, Gezim Bala, Luigi Pannone, Ingrid Overeinder, Ivan Eltsov, Juan Sieira, Erwin Stroker, Andrea Sarkozy, Carlo de Asmundis, Gian-Battista Chierchia","doi":"10.1111/jce.70509","DOIUrl":"10.1111/jce.70509","url":null,"abstract":"<p><strong>Background: </strong>A novel balloon-in-basket pulsed field ablation (PFA) system integrated with electroanatomical mapping has recently been introduced. However, real-world data on this technology, particularly for adjunctive posterior wall isolation (PWI) and extra-pulmonary vein sites, remain limited.</p><p><strong>Objective: </strong>To evaluate the acute performance, safety, and feasibility of pulmonary vein isolation (PVI) and adjunctive lesions using a balloon-in-basket PFA system.</p><p><strong>Methods: </strong>Consecutive patients with symptomatic paroxysmal or persistent AF undergoing ablation with the balloon-in-basket PFA system between February 2024 and February 2026 were included. Acute efficacy, procedural parameters, complications, exploratory haemolysis and renal biomarkers, and follow-up outcomes were assessed.</p><p><strong>Results: </strong>A total of 133 patients were included; 94 (70.7%) had paroxysmal AF and 39 (29.3%) persistent AF. Acute PVI was achieved in 96.2% of cases. Adjunctive PWI was performed in 25.6% of patients, and additional extra-PV lesion sets were performed in 12 patients. Mean procedure, left atrial dwelling, and fluoroscopy times were 65.6 ± 16.4, 45.4 ± 15.4, and 12.7 ± 7.3 min, respectively, with no significant differences between PVI-only and PVI + PWI procedures. Two periprocedural complications occurred (1.5%; femoral arterial pseudoaneurysm, pericarditis). Exploratory biomarker analyses showed no evident haemolysis-related renal safety signal. Among 82 patients with ≥ 6 months of follow-up, late clinically documented atrial arrhythmia recurrence occurred in 14.6%.</p><p><strong>Conclusion: </strong>In this real-world experience, the balloon-in-basket PFA system showed high acute efficacy, low complication rates, and efficient workflow. Adjunctive PWI appeared feasible in selected patients, with exploratory comparisons showing no evident increase in procedural burden or additional biomarker safety signal.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2356-2364"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crista Caval Line: Lattice-Tip Pulsed Field Ablation for Right Atrial Substrate Modification.","authors":"Shuhei Arai, Yuya Nakamura, Rimpei Ueno, Yosuke Kai, Masaya Ochiai, Takamasa Ishikawa, Haruka Miyazaki, Kosuke Yoshikawa, Taku Asano, Toshiro Shinke","doi":"10.1111/jce.70520","DOIUrl":"10.1111/jce.70520","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein isolation remains central to atrial fibrillation (AF) ablation, yet right atrial substrate modification remains incompletely defined. The crista terminalis (CT) region lies close to the right phrenic nerve and may exhibit anisotropic conduction and native or functional conduction block, while also serving as a potential non-pulmonary-vein trigger site. We evaluated the acute feasibility and electroanatomic endpoint of the Crista Caval Line (CCL), a CT-guided, sinoatrial node (SN)-sparing lesion set created with lattice-tip pulsed field ablation (PFA).</p><p><strong>Methods and results: </strong>We prospectively enrolled 36 consecutive patients undergoing CCL creation during repeat AF ablation or ablation for non-paroxysmal AF. Pre-CCL sinus-rhythm high-density right atrial activation mapping was performed in all patients. CT-related conduction delay or block was observed in 27 patients (75.0%). In 14 patients (38.9%) with an apparent CT block line, the inferior application-set edge was aligned to the block line; in the remaining 22 patients without an apparent block, placement was primarily guided by intracardiac echocardiography. The CCL was positioned posterior to the CT, with the lateral margin of its superior application set kept approximately 15 mm posterolateral to the earliest mapped sinus activation site for SN protection. The CCL measured 78.8 [66.4-86.0] mm from first to last tag and required 26 [22-30] PFA applications over 370 [282-481] s. First-pass bidirectional transverse conduction block was confirmed in all patients by postablation activation mapping and differential pacing from both sides of the CCL. Next-day inspiratory/expiratory chest radiography showed no abnormality suggestive of phrenic nerve palsy; no pacemaker-requiring SN dysfunction or other clinically apparent collateral injury occurred.</p><p><strong>Conclusions: </strong>A CT-guided, SN-sparing CCL can be reproducibly created with lattice-tip PFA, producing a first-pass bidirectional transverse conduction block without clinically apparent phrenic nerve palsy. These findings establish acute feasibility and an electroanatomic endpoint; lesion durability, arrhythmia recurrence, and incremental clinical benefit require further study.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2417-2420"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Progression to Permanent Atrial Fibrillation After Cryoballoon Pulmonary Vein Isolation: Insights From the Multicenter 1STOP Project.","authors":"Valeria Rella, Giuseppe Stabile, Giulio Molon, Paolo Pieragnoli, Giuseppe Arena, Claudio Tondo, Emanuele Bertaglia, Saverio Iacopino, Enrico Chieffo, Francesco Brasca, Massimiliano Manfrin, Umberto Startari, Roberto Rordorf, Massimiliano Marini, Laura Perrotta, Giovanni Battista Perego","doi":"10.1111/jce.70510","DOIUrl":"10.1111/jce.70510","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) often progresses from paroxysmal to persistent forms, culminating in permanent AF, a transition associated with increased risks of stroke, heart failure, and hospitalization. Cryoballoon pulmonary vein isolation (CB-PVI) is an established rhythm-control strategy; however, long-term data on AF progression following ablation remain limited. This study aimed to assess the incidence of progression to permanent AF after CB-PVI and to identify clinical predictors of such progression to guide patient management.</p><p><strong>Methods: </strong>We analyzed 1330 consecutive patients enrolled in the prospective, multicenter 1STOP registry who underwent CB-PVI between 2012 and 2018 across 13 Italian centers, with ≥ 5 years of follow-up. Baseline clinical, echocardiographic, and procedural characteristics were prospectively collected.</p><p><strong>Results: </strong>During a median follow-up of 81 months, 93 patients (7.0%) progressed to permanent AF. Independent predictors of progression included baseline persistent AF (HR ≈ 2.2, p < 0.001), need for cardioversion during index procedure (HR ≈ 2.2, p = 0.001), and older age (HR 1.05 per year, p < 0.001). Patients progressing to permanent AF had larger left atrium dimensions, higher CHA₂DS₂-VA scores, and a greater burden of comorbidities. Among patients experiencing AF recurrence, those undergoing repeat ablation had lower rates of progression compared to those without reintervention (11.0% vs. 17.6%).</p><p><strong>Conclusion: </strong>In this large multicenter cohort, long-term progression to permanent AF after CB-PVI was relatively uncommon (7%). Baseline AF type, age, and intra-procedural cardioversion independently predicted progression. Early rhythm-control strategies and individualized risk stratification may help delay the transition to permanent AF and improve long-term rhythm outcomes.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2365-2374"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical Response to Para-Hisian Pacing; What Is the Mechanism?","authors":"Guilherme Portugal, Sérgio Laranjo, Mário Oliveira","doi":"10.1111/jce.70507","DOIUrl":"10.1111/jce.70507","url":null,"abstract":"","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2424-2426"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Right- Versus Left-Sided Transvenous Lead Extraction.","authors":"Nadine Molitor, Caroline Wiederkehr, Jan Steffel, Andreas Häberlin, Alexander Breitenstein, Daniel Hofer","doi":"10.1111/jce.70497","DOIUrl":"10.1111/jce.70497","url":null,"abstract":"<p><strong>Background and aims: </strong>Transvenous lead extraction (TLE) is increasingly performed for malfunction or infection of cardiac implantable electronic devices. Because of anatomic differences, TLE for right-sided (RS) electrodes may differ in outcome. This study aimed to evaluate whether RS TLE differs in patient characteristics and outcomes compared to left-sided TLE.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who underwent TLE at the University Hospital Zurich from 2013 until 2023 regarding clinical and radiological success and complications.</p><p><strong>Results: </strong>A total of 556 patients underwent 568 TLE from January 2013 until December 2023. Patients with RS TLE procedures (n = 147, 25.9%) were older, more often PM-dependent, had longer lead dwell time, more leads with passive fixation and were more often extracted for infection. RS TLE procedures had a longer procedure duration (130 vs. 108 min, p = 0.002), more often needed a snare-bailout strategy (22% vs. 10%, p = 0.0.45), resulted in lower radiological success rates (88.4% vs. 93.8%, p = 0.045) and more major as well as minor complication rates.</p><p><strong>Conclusion: </strong>In our retrospective single-center analysis, RS TLE Procedures were more challenging concerning patient characteristics and resulted in lower TLE success as well as higher complication rates.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2341-2347"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Energy Bipolar Radiofrequency Ablation Combined With a Needle Electrode Connected in a Parallel Electrical Circuit to Create an Isolated Intramyocardial Lesion.","authors":"Osamu Saitoh, Takumi Kasai, Ryosuke Inomata, Hiroshi Furushima, Masaomi Chinushi","doi":"10.1111/jce.70508","DOIUrl":"10.1111/jce.70508","url":null,"abstract":"<p><strong>Background: </strong>An ideal ablation method to create lesions inside the thick myocardium has not been well established. This experimental study was performed to assess whether low energy bipolar (BIP) radiofrequency (RF) ablation combined with a needle electrode can create an isolated intramyocardial lesion with minimum risk of steam-pop.</p><p><strong>Methods: </strong>A coronary perfused porcine myocardial segment was placed in an experimental setting, and two irrigation catheters were placed on the opposite endocardial and epicardial surfaces. An originally made plastic needle (equipped with a 3-mm electrode tip and a temperature sensor) was inserted into the middle myocardial region, approximately in line with and centered between the two ablation catheters. Cable-ends of the epicardial catheter and the plastic needle electrode were together plugged into the cutaneous electrode connector, whereas the cable-end of the endocardial catheter was plugged into the catheter connector of the generator. 10 W for either 60 or 90 s (18 applications each) was delivered simultaneously between the distal tips of the two ablation catheters and between the needle electrode and the endocardial ablation catheter.</p><p><strong>Results: </strong>All 36 applications were successfully accomplished without steam-pop, and created an isolated intramyocardial lesion. Vertical/horizontal lesion diameters and maximum intramyocardial temperature were 7.3 ± 0.8/6.3 ± 0.7 mm and 87.9°C ± 6.2°C in the 60-second, and 9.1 ± 1.0/8.0 ± 1.1 mm and 95.6°C ± 4.7°C in the 90-second applications. No visual lesion was created on the myocardial surface.</p><p><strong>Conclusions: </strong>Although the present study is a first step in this ablation method, BIP ablation combined with a needle electrode may have the potential to create an isolated intramural lesion with minimum risk of steam-pop under local temperature monitoring.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2348-2355"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensor-Driven Pacemaker Tachycardia During Chest Physiotherapy: The Hidden Accelerometer Sensor Response in a Leadless Pacemaker in the VDD Mode.","authors":"Chu-Pak Lau, Kathy Lai-Fun Lee, Hung-Fat Tse","doi":"10.1111/jce.70496","DOIUrl":"10.1111/jce.70496","url":null,"abstract":"<p><strong>Introduction: </strong>Leadless pacemakers (LPM) provide ventricular pacing, atrio-ventricular (AV) synchrony and rate response.</p><p><strong>Background: </strong>In the VDD mode, the single-chamber LPM is capable of atrial sensing with additional accelerometer activity sensing rate response.</p><p><strong>Methods and results: </strong>An 85-year-old man with tachy-bradycardia received a Micra AV2 (Medtronic Inc). During chest physiotherapy, pulse rate increased to over 100 bpm during chest percussion when performed on the left side. This was due to VDD mode switching to VVIR pacing when the accelerometer sensor rate exceeded the atrial rate. Inactivation of mode switching prevented rate acceleration.</p><p><strong>Conclusion: </strong>Chest physiotherapy caused unexpected rate increase in LPM even in VDD mode.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2427-2430"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First United States Experience With Focal Pulsed-Field Ablation Using the FARAPOINT Catheter for Refractory Ventricular Tachycardia.","authors":"Jorge L Reyes, Rezwan Munshi, Collin Goebel, Venkat Tholakanahalli","doi":"10.1111/jce.70498","DOIUrl":"10.1111/jce.70498","url":null,"abstract":"<p><strong>Background: </strong>Drug-refractory ventricular tachycardia (VT) after failed radiofrequency (RF) ablation remains a clinical challenge. Pulsed-field ablation (PFA) is expanding to ventricular applications, but United States experience with focal pulsed-field-only catheters in VT is sparse, and pulsed-field platforms are not equivalent across manufacturers. Here we describe the first United States experience of FARAPOINT focal PFA in patients with refractory VT.</p><p><strong>Methods and results: </strong>We retrospectively reviewed ten consecutive patients who underwent VT ablation with the FARAPOINT (Boston Scientific) focal PFA catheter at a single VA Health Care System between July 2025 and May 2026. All patients had drug-refractory sustained monomorphic VT. Median age was 77 years with a mix of ischemic and nonischemic cardiomyopathy. Six of ten had at least one prior failed catheter ablation. Acute non-inducibility was achieved in all nine patients who underwent formal post-ablation stimulation testing. No procedural complications occurred. Over a median follow-up of 95.5 days, sustained VT recurred in four of ten patients. No patient underwent repeat ablation, required mechanical circulatory support, or died.</p><p><strong>Conclusions: </strong>In this initial United States experience, FARAPOINT was safe and acutely effective in patients with ischemic cardiomyopathy within a high-risk cohort with refractory VT and prior failed ablations, including challenging substrates. Prospective multicenter studies are warranted to expand these observations.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2409-2412"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Cardiorespiratory-Gated Proton Beam Delivery for Stereotactic Arrhythmia Radioablation.","authors":"Jagdip Kang, Felicitas J Bijari, Yanis Chemli, Yen-Lin Chen, Helen Deng, Nicolas Depauw, Maeva Dhaynaut, Adriano Garonna, Hyeongseok Kim, Marina Macdonald-Soccorso, Sung-Hyun Moon, Marc D Normandin, Rebecca Woodcock, K Moshe Yaghoubian, Georges El Fakhri, Robert Levine, Kyung-Wook Jee, H Immo Lehmann","doi":"10.1111/jce.70512","DOIUrl":"10.1111/jce.70512","url":null,"abstract":"<p><strong>Aims: </strong>Stereotactic arrhythmia radioablation (STAR) is a promising noninvasive therapy for refractory ventricular tachycardia. Using scanned proton beams for STAR enables precisely focused, high doses of ionizing radiation. Effective mitigation of target motion is critical for safety but remains challenging due to the complex interplay between beam scanning and cardiorespiratory motion. We evaluated the safety and feasibility of accurately delivering gated scanned proton beams to a ventricular myocardial target and compared lesion outcomes of respiratory (single)- and cardiorespiratory (dual)-gated proton beams.</p><p><strong>Methods: </strong>Six pigs (the first two used as a test of the protocol) underwent baseline CT for treatment planning with a single fractional dose of 35 Gy to a myocardial target in the left ventricular free wall. They were subsequently treated with either single- or dual-gated delivery using scanned proton beams. Treatment response was evaluated by echocardiography, blood analysis and positron emission tomography (PET)-CT at baseline and 14-15 weeks after irradiation. Lesions were assessed at termination, and tissues were harvested for histopathology.</p><p><strong>Results: </strong>Average target expansion for intrafractional motion was lower with dual compared to single gating (16%-23% vs. 48%-72%, N = 2 in each arm). The irradiated area was distinguishable in vivo on PET-CT and ex vivo in necropsy at the expected location in all animals. Visual lesion transmurality was confirmed by histology. Lesion sizes were not far from the expected volumes in dual-gated animals but were larger in single-gated animals (p = 0.3 for between-group comparison, N = 2 in each arm).</p><p><strong>Conclusions: </strong>The results confirmed the feasibility of the workflow. Dual-gated irradiation was associated with reduced radiation exposure of the myocardium outside the target volume, and with lesion sizes closer to those planned.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2375-2384"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Safety and Outcome Using Three Different Sedation Strategies During Pulsed Field Ablation for Atrial Fibrillation.","authors":"Christina Alhede, Laurits Juhl Heinsen, Mille Ravn Sandgaard, Jacob Pontoppidan, Katrine Væsel Wade, Uffe Gang, Steen Buus Kristiansen, Arne Johannessen, Armin Osmanagic, Camilla Lundegaard Asferg, Peter Steen Hansen, Sam Riahi, Martin H Ruwald, Peter Karl Jacobsen, Niels C F Sandgaard","doi":"10.1111/jce.70516","DOIUrl":"10.1111/jce.70516","url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is an emerging modality for atrial fibrillation (AF) ablation. However, adequate sedation of patients during treatment is imperative.</p><p><strong>Objective: </strong>Our aim was to compare safety and outcome after deep sedation (DS) managed by electrophysiology staff (EP-DS), DS by an anaesthesia nurse (AN-DS), and general anaesthesia (GA) during PFA AF ablation.</p><p><strong>Methods: </strong>All Danish patients undergoing first-time AF ablation with pentaspline PFA technique from 2021 to 2024 were included. Patients were stratified according to sedation strategy. EP-DS and AN-DS were defined as sedation without assisted ventilation managed by EP staff and an anaesthesia nurse, respectively. Patients in GA underwent endotracheal intubation and were monitored by anaesthesia staff. Patient selection for the sedation strategy was based on the institutional practice.</p><p><strong>Results: </strong>Of 1269 patients, 661 (52%) underwent EP-DS, 173 (14%) underwent AN-DS, and 435 (34%) underwent GA. Overall, sedation complications were few, and no procedures were abandoned due to adverse effects of sedation. In the EP-DS group, the anaesthesiologist was unexpectedly called for back-up in 1 (0.2%) patient due to prolonged hypotension during the procedure. In the AN-DS group, the anaesthesiologist was called due to desaturation in 1 patient (0.6%) but without the need for escalation to intubation. In the GA group, no periprocedural sedation complications occurred. We found no difference in 1-year atrial tachycardia recurrence between sedation groups.</p><p><strong>Conclusion: </strong>In this nationwide cohort, EP staff-administered deep sedation was feasible and associated with few clinically significant sedation-related adverse events during PFA. No significant differences in observed atrial tachyarrhythmia recurrence rates were identified between sedation strategies.</p>","PeriodicalId":15178,"journal":{"name":"Journal of Cardiovascular Electrophysiology","volume":" ","pages":"2393-2402"},"PeriodicalIF":2.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}