TY - JOUR
T1 - Pulsed field ablation for atrial fibrillation ablation
T2 - a European Heart Rhythm Association survey
AU - Bergonti, Marco
AU - Mills, Mark T.
AU - Roten, Laurent
AU - Ruwald, Martin H.
AU - Metzner, Andreas
AU - Conte, Giulio
AU - Zylla, Maura M.
AU - Vlachos, Konstantinos
AU - Mazurek, Michal
AU - Perrotta, Laura
AU - Futyma, Piotr
AU - Sultan, Arian
AU - Heeger, Christian Hendrick
AU - Chun, Julian K.R.
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2025/12/1
Y1 - 2025/12/1
N2 - Aims: Pulsed field ablation (PFA) has rapidly emerged as a non-thermal ablation technology for pulmonary vein isolation (PVI), with an unprecedented adoption across Europe. The aim of this survey was to characterize current practice patterns. Methods and results: The European Heart Rhythm Association (EHRA) Scientific Initiatives Committee designed a 30-item questionnaire addressing temporal adoption of PFA, pre-, intra-, and post-procedural workflows, and future perspectives. The survey was distributed between April and June 2025. A total of 216 responses were obtained from 43 countries. At the time of the survey, 23% of respondents had not yet initiated a PFA programme. Overall, PFA is now used in half (49%) of first atrial fibrillation (AF) ablation procedures. Adoption was significantly higher in high-volume centres and ‘Western European’ countries. The primary driver for adoption was time efficiency (60%). Intra-procedural workflows showed marked heterogeneity: approximately half of the operators relied exclusively on fluoroscopy without any intra-procedural imaging/mapping. Additional ablation lesions beyond PVI were common, with one-third employing standardized PVI+ protocols in persistent AF, most frequently posterior wall isolation. General anaesthesia and deep sedation were used in equal proportions. Conclusion: This EHRA survey demonstrates both rapid implementation and significant heterogeneity in PFA use across Europe. Standardized protocols and prospective studies are needed to define best practices.
AB - Aims: Pulsed field ablation (PFA) has rapidly emerged as a non-thermal ablation technology for pulmonary vein isolation (PVI), with an unprecedented adoption across Europe. The aim of this survey was to characterize current practice patterns. Methods and results: The European Heart Rhythm Association (EHRA) Scientific Initiatives Committee designed a 30-item questionnaire addressing temporal adoption of PFA, pre-, intra-, and post-procedural workflows, and future perspectives. The survey was distributed between April and June 2025. A total of 216 responses were obtained from 43 countries. At the time of the survey, 23% of respondents had not yet initiated a PFA programme. Overall, PFA is now used in half (49%) of first atrial fibrillation (AF) ablation procedures. Adoption was significantly higher in high-volume centres and ‘Western European’ countries. The primary driver for adoption was time efficiency (60%). Intra-procedural workflows showed marked heterogeneity: approximately half of the operators relied exclusively on fluoroscopy without any intra-procedural imaging/mapping. Additional ablation lesions beyond PVI were common, with one-third employing standardized PVI+ protocols in persistent AF, most frequently posterior wall isolation. General anaesthesia and deep sedation were used in equal proportions. Conclusion: This EHRA survey demonstrates both rapid implementation and significant heterogeneity in PFA use across Europe. Standardized protocols and prospective studies are needed to define best practices.
KW - Ablation
KW - Atrial fibrillation
KW - Pulmonary vein isolation
KW - Pulsed field ablation
UR - http://www.scopus.com/inward/record.url?scp=105024146045&partnerID=8YFLogxK
U2 - 10.1093/europace/euaf294
DO - 10.1093/europace/euaf294
M3 - Journal article
C2 - 41363248
AN - SCOPUS:105024146045
SN - 1099-5129
VL - 27
JO - Europace
JF - Europace
IS - 12
M1 - euaf294
ER -