Pulsed field ablation for atrial fibrillation ablation: a European Heart Rhythm Association survey
Year: 2025
Type: article
Study design: Observational Study
Abstract: 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.
Source: EP Europace
Institutions: Ente Ospedaliero Cantonale, Istituto Cardiocentro Ticino, University of Liverpool, Liverpool Heart and Chest Hospital NHS Trust, Liverpool Heart and Chest Hospital, Liverpool John Moores University, University of Bern, University Hospital of Bern, Herlev Hospital, Gentofte Hospital, Universität Hamburg, University Medical Center Hamburg-Eppendorf, Università della Svizzera italiana, Heidelberg University, University Hospital Heidelberg, Centre Hospitalier Universitaire de Bordeaux, Electrophysiology and Heart Modeling Institute, Silesian Center for Heart Disease, Azienda Ospedaliero-Universitaria Careggi, University of Rzeszów, University Hospital Cologne, Asklepios Klinik Altona, Asklepios, Agaplesion Markus Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,909
OpenAlex ID: W4417183972