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. 2025 Apr 25;6(7):911-919.
doi: 10.1016/j.hroo.2025.04.005. eCollection 2025 Jul.

Countrywide introduction of pulsed field ablation for the treatment of atrial fibrillation: Acute results from the FRANCE-PFA registry

Corentin Chaumont  1 , Mikael Laredo  2 , Olivier Thomas  3 , Philippe Maury  4 , Grégoire Massoulié  5 , Pascal Defaye  6 , Serge Boveda  7 , Eloi Marijon  8 , William Escande  9 , Antoine Roux  10 , Franck Raczka  11 , Yves Guyomar  12 , Pierre Jaïs  13 , Pierre Ollitrault  14 , Mathieu Granier  15 , Samir Fareh  16 , Hugo Marchand  17 , Bertrand Pierre  18 , Selim Abbey  19 , Antoine Noel  20 , Antoine Da Costa  21 , Fabrice Extramiana  22 , Olivier Cesari  23 , Laure Champ-Rigot  14 , Ziad Khoueiry  24 , Thibault Villemin  25 , Sarah Traullé  26 , Frédéric Treguer  27 , Hugues Bader  28 , Jean-Claude Deharo  29 , Bruno Degand  30 , Benoît Guy-Moyat  31 , Didier Klug  32 , Estelle Gandjbakhch  2 , Alexandre Zhao  3 , Maxime Beneyto  4 , Romain Eschalier  5 , Sandrine Venier  6 , Stéphane Combes  7 , Antoine Lepillier  9 , Marc Mielczarek  10 , Nicolas Clementy  11 , Aymeric Menet  12 , Frédéric Sacher  13 , Christian De Chillou  33 , Frédéric Anselme  1
Affiliations

Countrywide introduction of pulsed field ablation for the treatment of atrial fibrillation: Acute results from the FRANCE-PFA registry

Corentin Chaumont et al. Heart Rhythm O2. .

Abstract

Background: Most data on atrial fibrillation (AF) ablation using the first available pentaspline pulsed field ablation (PFA) catheter (Farapulse, Boston Scientific Inc) come from retrospective center-level registries collected in highly experienced centers.

Objective: This study aimed to provide exhaustive and prospective patient-level data on this new ablation modality.

Methods: FRANCE-PFA is a nationwide registry (NCT06497933) that included all patients undergoing a first AF ablation using the pentaspline PFA catheter since the introduction of this technology in France. All French centers using this technology participated. Procedural data were prospectively collected at a patient level.

Results: This registry included 5223 patients from 33 centers between March 2021 and February 2024 (mean age 65 ± 11 years, 55.4% paroxysmal AF). The procedure duration was 54 ± 23 minutes. Acute pulmonary vein isolation was achieved in 5211 patients (99.8%). The total number of PFA applications was 50 ± 22 with >70 applications in 746 patients (14.3%). Pulmonary vein isolation only was performed in 64.7% of patients (82.7% of paroxysmal AF, 44.5% of persistent AF, and 26.6% of long-standing persistent AF). The most common location for additional PFA lesion sets was the left atrium posterior wall in 1335 patients (25.6%), left atrium roof in 999 patients (19.1%), and mitral isthmus in 514 patients (9.8%). Major complications occurred in 50 patients (0.96%), with no esophageal complication or symptomatic phrenic nerve palsy reported in past hospital discharge.

Conclusion: In this prospective and nationwide registry, AF ablation using the pentaspline PFA catheter seemed to be safe and acutely efficient, despite considerable heterogeneity in the number of patients treated at each center.

Trial registration: NCT06497933.

Keywords: Atrial fibrillation; Catheter ablation; Pulmonary vein isolation; Pulsed field ablation; Registry.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Flowchart. AF = atrial fibrillation; PVI = pulmonary vein isolation.
Figure 2
Figure 2
Trend in inclusions and participating centers over time. Note the strong progression in the use of PFA in France, with most procedures (80%) performed in 2023 and early 2024. More than half of the centers (18 of 33) have adopted PFA after March 2023. PFA = pulsed field ablation.
Figure 3
Figure 3
Occurrence of major complications over time at each center. The horizontal lines represent the number of patients treated at each of the 33 centers. Complications are displayed per center in chronological order. TIA = transient ischemic attack; VT = ventricular tachycardia.
Figure 4
Figure 4
Results of the questionnaire on PFA implementation across the participating centers. A: Percentage of first-time AF ablation procedure performed using PFA. B: Increase in the number of first-time AF ablation procedures in relation to use of PFA. AF = atrial fibrillation; PFA = pulsed field ablation.
See this image and copyright information in PMC

References

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