Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

Emmanuel Ekanem; Petr Neuzil; Tobias Reichlin; Joseph Kautzner; Pepijn van der Voort; Pierre Jais; Gian Battista Chierchia; Alan Bulava; Yuri Blaauw; Tomas Skala; Martin Fiala; Mattias Duytschaever; Gabor Szeplaki; Boris Schmidt; Grégoire Massoullie; Kars Neven; Olivier Thomas; Johan Vijgen; Estelle Gandjbakhch; Daniel Scherr; Arne Johannessen; David Keane; Serge Boveda; Philippe Maury; Ignacio García-Bolao; Ante Anic; Peter Steen Hansen; Franck Raczka; Antoine Lepillier; Yves Guyomar; Dhiraj Gupta; Jurren Van Opstal; Pascal Defaye; Christian Sticherling; Philipp Sommer; Pavel Kucera; Joaquin Osca; Fariborz Tabrizi; Antoine Roux; Michael Gramlich; Stefano Bianchi; Pedro Adragão; Francesco Solimene; Claudio Tondo; Antonio Dello Russo; Jürgen Schreieck; Armin Luik; Obaida Rana; Gerrit Frommeyer; Frédéric Anselme; Ingo Kreis; Raphael Rosso; Andreas Metzner; Laszlo Geller; Samuel H. Baldinger; Angel Ferrero; Stephan Willems; Andreas Goette; Greg Mellor; Shibu Mathew; Lukasz Szumowski; Roland Tilz; Saverio Iacopino; Peter Karl Jacobsen; Andrikopoulos George; Pavel Osmancik; Stefan Spitzer; Richard Balasubramaniam; Abdul Shokor Parwani; Thomas Deneke; Andrzej Glowniak; Antonio Rossillo; Helmut Pürerfellner; David Duncker; Peter Reil; Thomas Arentz; Daniel Steven; Juan José Olalla; Jonas S.S.G. de Jong; Reza Wakili; Selim Abbey; Gottschling Timo; Antonio Asso; Tom Wong; Bertrand Pierre; Niels Christian Ewertsen; Leonard Bergau; Cristina Lozano-Granero; Maximo Rivero; Alexander Breitenstein; Jaakko Inkovaara; Samir Fareh; Decebal Gabriel Latcu; Dominik Linz; Patrick Müller; Javier Ramos-Maqueda; Thomas Beiert; Sakis Themistoclakis; Dirk Grosse Meininghaus; Günter Stix; Stylianos Tzeis; Jakub Baran; Henrik Almroth; Daniel Rodriguez Munoz; João de Sousa; Michalis Efremidis; Pawel Balsam; Jan Petru; Thomas Küffer; Petr Peichl; Lukas Dekker; Domenico G. Della Rocca; Ondrej Moravec; Moritoshi Funasako; Sebastien Knecht; Gael Jauvert; Julian Chun; Romain Eschalier; Anna Füting; Alexandre Zhao; Pieter Koopman; Mikael Laredo; Martin Manninger; Jim Hansen; Daniel O’Hare; Anne Rollin; Zrinka Jurisic; Thomas Fink; Corentin Chaumont; Andreas Rillig; Melanie Gunawerdene; Claire Martin; Bettina Kirstein; Karin Nentwich; Heiko Lehrmann; Arian Sultan; Jan Bohnen; Mohit K. Turagam; Vivek Y. Reddy

doi:10.1038/s41591-024-03114-3

Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

Emmanuel Ekanem, Petr Neuzil, Tobias Reichlin, Joseph Kautzner, Pepijn van der Voort, Pierre Jais, Gian Battista Chierchia, Alan Bulava, Yuri Blaauw, Tomas Skala, Martin Fiala, Mattias Duytschaever, Gabor Szeplaki, Boris Schmidt, Grégoire Massoullie, Kars Neven, Olivier Thomas, Johan Vijgen, Estelle Gandjbakhch, Daniel ScherrArne Johannessen, David Keane, Serge Boveda, Philippe Maury, Ignacio García-Bolao, Ante Anic, Peter Steen Hansen, Franck Raczka, Antoine Lepillier, Yves Guyomar, Dhiraj Gupta, Jurren Van Opstal, Pascal Defaye, Christian Sticherling, Philipp Sommer, Pavel Kucera, Joaquin Osca, Fariborz Tabrizi, Antoine Roux, Michael Gramlich, Stefano Bianchi, Pedro Adragão, Francesco Solimene, Claudio Tondo, Antonio Dello Russo, Jürgen Schreieck, Armin Luik, Obaida Rana, Gerrit Frommeyer, Frédéric Anselme, Ingo Kreis, Raphael Rosso, Andreas Metzner, Laszlo Geller, Samuel H. Baldinger, Angel Ferrero, Stephan Willems, Andreas Goette, Greg Mellor, Shibu Mathew, Lukasz Szumowski, Roland Tilz, Saverio Iacopino, Peter Karl Jacobsen, Andrikopoulos George, Pavel Osmancik, Stefan Spitzer, Richard Balasubramaniam, Abdul Shokor Parwani, Thomas Deneke, Andrzej Glowniak, Antonio Rossillo, Helmut Pürerfellner, David Duncker, Peter Reil, Thomas Arentz, Daniel Steven, Juan José Olalla, Jonas S.S.G. de Jong, Reza Wakili, Selim Abbey, Gottschling Timo, Antonio Asso, Tom Wong, Bertrand Pierre, Niels Christian Ewertsen, Leonard Bergau, Cristina Lozano-Granero, Maximo Rivero, Alexander Breitenstein, Jaakko Inkovaara, Samir Fareh, Decebal Gabriel Latcu, Dominik Linz, Patrick Müller, Javier Ramos-Maqueda, Thomas Beiert, Sakis Themistoclakis, Dirk Grosse Meininghaus, Günter Stix, Stylianos Tzeis, Jakub Baran, Henrik Almroth, Daniel Rodriguez Munoz, João de Sousa, Michalis Efremidis, Pawel Balsam, Jan Petru, Thomas Küffer, Petr Peichl, Lukas Dekker, Domenico G. Della Rocca, Ondrej Moravec, Moritoshi Funasako, Sebastien Knecht, Gael Jauvert, Julian Chun, Romain Eschalier, Anna Füting, Alexandre Zhao, Pieter Koopman, Mikael Laredo, Martin Manninger, Jim Hansen, Daniel O’Hare, Anne Rollin, Zrinka Jurisic, Thomas Fink, Corentin Chaumont, Andreas Rillig, Melanie Gunawerdene, Claire Martin, Bettina Kirstein, Karin Nentwich, Heiko Lehrmann, Arian Sultan, Jan Bohnen, Mohit K. Turagam, Vivek Y. Reddy^*

^*Corresponding author af dette arbejde

Physiology of circulation, kidney and lung

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

102 Citationer (Scopus)

14 Downloads (Pure)

Abstract

Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.

Originalsprog	Engelsk
Tidsskrift	Nature Medicine
Vol/bind	30
Sider (fra-til)	2020–2029
ISSN	1078-8956
DOI	https://doi.org/10.1038/s41591-024-03114-3
Status	Udgivet - 2024

Bibliografisk note

Publisher Copyright:
© The Author(s) 2024.

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Citationsformater

Ekanem, E., Neuzil, P., Reichlin, T., Kautzner, J., van der Voort, P., Jais, P., Chierchia, G. B., Bulava, A., Blaauw, Y., Skala, T., Fiala, M., Duytschaever, M., Szeplaki, G., Schmidt, B., Massoullie, G., Neven, K., Thomas, O., Vijgen, J., Gandjbakhch, E., ... Reddy, V. Y. (2024). Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study. Nature Medicine, 30, 2020–2029. https://doi.org/10.1038/s41591-024-03114-3

Ekanem, E, Neuzil, P, Reichlin, T, Kautzner, J, van der Voort, P, Jais, P, Chierchia, GB, Bulava, A, Blaauw, Y, Skala, T, Fiala, M, Duytschaever, M, Szeplaki, G, Schmidt, B, Massoullie, G, Neven, K, Thomas, O, Vijgen, J, Gandjbakhch, E, Scherr, D, Johannessen, A, Keane, D, Boveda, S, Maury, P, García-Bolao, I, Anic, A, Hansen, PS, Raczka, F, Lepillier, A, Guyomar, Y, Gupta, D, Van Opstal, J, Defaye, P, Sticherling, C, Sommer, P, Kucera, P, Osca, J, Tabrizi, F, Roux, A, Gramlich, M, Bianchi, S, Adragão, P, Solimene, F, Tondo, C, Russo, AD, Schreieck, J, Luik, A, Rana, O, Frommeyer, G, Anselme, F, Kreis, I, Rosso, R, Metzner, A, Geller, L, Baldinger, SH, Ferrero, A, Willems, S, Goette, A, Mellor, G, Mathew, S, Szumowski, L, Tilz, R, Iacopino, S, Jacobsen, PK, George, A, Osmancik, P, Spitzer, S, Balasubramaniam, R, Parwani, AS, Deneke, T, Glowniak, A, Rossillo, A, Pürerfellner, H, Duncker, D, Reil, P, Arentz, T, Steven, D, Olalla, JJ, de Jong, JSSG, Wakili, R, Abbey, S, Timo, G, Asso, A, Wong, T, Pierre, B, Ewertsen, NC, Bergau, L, Lozano-Granero, C, Rivero, M, Breitenstein, A, Inkovaara, J, Fareh, S, Latcu, DG, Linz, D, Müller, P, Ramos-Maqueda, J, Beiert, T, Themistoclakis, S, Meininghaus, DG, Stix, G, Tzeis, S, Baran, J, Almroth, H, Munoz, DR, de Sousa, J, Efremidis, M, Balsam, P, Petru, J, Küffer, T, Peichl, P, Dekker, L, Della Rocca, DG, Moravec, O, Funasako, M, Knecht, S, Jauvert, G, Chun, J, Eschalier, R, Füting, A, Zhao, A, Koopman, P, Laredo, M, Manninger, M, Hansen, J, O’Hare, D, Rollin, A, Jurisic, Z, Fink, T, Chaumont, C, Rillig, A, Gunawerdene, M, Martin, C, Kirstein, B, Nentwich, K, Lehrmann, H, Sultan, A, Bohnen, J, Turagam, MK & Reddy, VY 2024, 'Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study', Nature Medicine, bind 30, s. 2020–2029. https://doi.org/10.1038/s41591-024-03114-3

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title = "Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study",

abstract = "Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.",

author = "Emmanuel Ekanem and Petr Neuzil and Tobias Reichlin and Joseph Kautzner and {van der Voort}, Pepijn and Pierre Jais and Chierchia, {Gian Battista} and Alan Bulava and Yuri Blaauw and Tomas Skala and Martin Fiala and Mattias Duytschaever and Gabor Szeplaki and Boris Schmidt and Gr{\'e}goire Massoullie and Kars Neven and Olivier Thomas and Johan Vijgen and Estelle Gandjbakhch and Daniel Scherr and Arne Johannessen and David Keane and Serge Boveda and Philippe Maury and Ignacio Garc{\'i}a-Bolao and Ante Anic and Hansen, {Peter Steen} and Franck Raczka and Antoine Lepillier and Yves Guyomar and Dhiraj Gupta and {Van Opstal}, Jurren and Pascal Defaye and Christian Sticherling and Philipp Sommer and Pavel Kucera and Joaquin Osca and Fariborz Tabrizi and Antoine Roux and Michael Gramlich and Stefano Bianchi and Pedro Adrag{\~a}o and Francesco Solimene and Claudio Tondo and Russo, {Antonio Dello} and J{\"u}rgen Schreieck and Armin Luik and Obaida Rana and Gerrit Frommeyer and Fr{\'e}d{\'e}ric Anselme and Ingo Kreis and Raphael Rosso and Andreas Metzner and Laszlo Geller and Baldinger, {Samuel H.} and Angel Ferrero and Stephan Willems and Andreas Goette and Greg Mellor and Shibu Mathew and Lukasz Szumowski and Roland Tilz and Saverio Iacopino and Jacobsen, {Peter Karl} and Andrikopoulos George and Pavel Osmancik and Stefan Spitzer and Richard Balasubramaniam and Parwani, {Abdul Shokor} and Thomas Deneke and Andrzej Glowniak and Antonio Rossillo and Helmut P{\"u}rerfellner and David Duncker and Peter Reil and Thomas Arentz and Daniel Steven and Olalla, {Juan Jos{\'e}} and {de Jong}, {Jonas S.S.G.} and Reza Wakili and Selim Abbey and Gottschling Timo and Antonio Asso and Tom Wong and Bertrand Pierre and Ewertsen, {Niels Christian} and Leonard Bergau and Cristina Lozano-Granero and Maximo Rivero and Alexander Breitenstein and Jaakko Inkovaara and Samir Fareh and Latcu, {Decebal Gabriel} and Dominik Linz and Patrick M{\"u}ller and Javier Ramos-Maqueda and Thomas Beiert and Sakis Themistoclakis and Meininghaus, {Dirk Grosse} and G{\"u}nter Stix and Stylianos Tzeis and Jakub Baran and Henrik Almroth and Munoz, {Daniel Rodriguez} and {de Sousa}, Jo{\~a}o and Michalis Efremidis and Pawel Balsam and Jan Petru and Thomas K{\"u}ffer and Petr Peichl and Lukas Dekker and {Della Rocca}, {Domenico G.} and Ondrej Moravec and Moritoshi Funasako and Sebastien Knecht and Gael Jauvert and Julian Chun and Romain Eschalier and Anna F{\"u}ting and Alexandre Zhao and Pieter Koopman and Mikael Laredo and Martin Manninger and Jim Hansen and Daniel O{\textquoteright}Hare and Anne Rollin and Zrinka Jurisic and Thomas Fink and Corentin Chaumont and Andreas Rillig and Melanie Gunawerdene and Claire Martin and Bettina Kirstein and Karin Nentwich and Heiko Lehrmann and Arian Sultan and Jan Bohnen and Turagam, {Mohit K.} and Reddy, {Vivek Y.}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024.",

year = "2024",

doi = "10.1038/s41591-024-03114-3",

language = "English",

volume = "30",

pages = "2020–2029",

journal = "Nature Medicine",

issn = "1078-8956",

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}

TY - JOUR

T1 - Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

AU - Ekanem, Emmanuel

AU - Neuzil, Petr

AU - Reichlin, Tobias

AU - Kautzner, Joseph

AU - van der Voort, Pepijn

AU - Jais, Pierre

AU - Chierchia, Gian Battista

AU - Bulava, Alan

AU - Blaauw, Yuri

AU - Skala, Tomas

AU - Fiala, Martin

AU - Duytschaever, Mattias

AU - Szeplaki, Gabor

AU - Schmidt, Boris

AU - Massoullie, Grégoire

AU - Neven, Kars

AU - Thomas, Olivier

AU - Vijgen, Johan

AU - Gandjbakhch, Estelle

AU - Scherr, Daniel

AU - Johannessen, Arne

AU - Keane, David

AU - Boveda, Serge

AU - Maury, Philippe

AU - García-Bolao, Ignacio

AU - Anic, Ante

AU - Hansen, Peter Steen

AU - Raczka, Franck

AU - Lepillier, Antoine

AU - Guyomar, Yves

AU - Gupta, Dhiraj

AU - Van Opstal, Jurren

AU - Defaye, Pascal

AU - Sticherling, Christian

AU - Sommer, Philipp

AU - Kucera, Pavel

AU - Osca, Joaquin

AU - Tabrizi, Fariborz

AU - Roux, Antoine

AU - Gramlich, Michael

AU - Bianchi, Stefano

AU - Adragão, Pedro

AU - Solimene, Francesco

AU - Tondo, Claudio

AU - Russo, Antonio Dello

AU - Schreieck, Jürgen

AU - Luik, Armin

AU - Rana, Obaida

AU - Frommeyer, Gerrit

AU - Anselme, Frédéric

AU - Kreis, Ingo

AU - Rosso, Raphael

AU - Metzner, Andreas

AU - Geller, Laszlo

AU - Baldinger, Samuel H.

AU - Ferrero, Angel

AU - Willems, Stephan

AU - Goette, Andreas

AU - Mellor, Greg

AU - Mathew, Shibu

AU - Szumowski, Lukasz

AU - Tilz, Roland

AU - Iacopino, Saverio

AU - Jacobsen, Peter Karl

AU - George, Andrikopoulos

AU - Osmancik, Pavel

AU - Spitzer, Stefan

AU - Balasubramaniam, Richard

AU - Parwani, Abdul Shokor

AU - Deneke, Thomas

AU - Glowniak, Andrzej

AU - Rossillo, Antonio

AU - Pürerfellner, Helmut

AU - Duncker, David

AU - Reil, Peter

AU - Arentz, Thomas

AU - Steven, Daniel

AU - Olalla, Juan José

AU - de Jong, Jonas S.S.G.

AU - Wakili, Reza

AU - Abbey, Selim

AU - Timo, Gottschling

AU - Asso, Antonio

AU - Wong, Tom

AU - Pierre, Bertrand

AU - Ewertsen, Niels Christian

AU - Bergau, Leonard

AU - Lozano-Granero, Cristina

AU - Rivero, Maximo

AU - Breitenstein, Alexander

AU - Inkovaara, Jaakko

AU - Fareh, Samir

AU - Latcu, Decebal Gabriel

AU - Linz, Dominik

AU - Müller, Patrick

AU - Ramos-Maqueda, Javier

AU - Beiert, Thomas

AU - Themistoclakis, Sakis

AU - Meininghaus, Dirk Grosse

AU - Stix, Günter

AU - Tzeis, Stylianos

AU - Baran, Jakub

AU - Almroth, Henrik

AU - Munoz, Daniel Rodriguez

AU - de Sousa, João

AU - Efremidis, Michalis

AU - Balsam, Pawel

AU - Petru, Jan

AU - Küffer, Thomas

AU - Peichl, Petr

AU - Dekker, Lukas

AU - Della Rocca, Domenico G.

AU - Moravec, Ondrej

AU - Funasako, Moritoshi

AU - Knecht, Sebastien

AU - Jauvert, Gael

AU - Chun, Julian

AU - Eschalier, Romain

AU - Füting, Anna

AU - Zhao, Alexandre

AU - Koopman, Pieter

AU - Laredo, Mikael

AU - Manninger, Martin

AU - Hansen, Jim

AU - O’Hare, Daniel

AU - Rollin, Anne

AU - Jurisic, Zrinka

AU - Fink, Thomas

AU - Chaumont, Corentin

AU - Rillig, Andreas

AU - Gunawerdene, Melanie

AU - Martin, Claire

AU - Kirstein, Bettina

AU - Nentwich, Karin

AU - Lehrmann, Heiko

AU - Sultan, Arian

AU - Bohnen, Jan

AU - Turagam, Mohit K.

AU - Reddy, Vivek Y.

PY - 2024

Y1 - 2024

N2 - Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.

AB - Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.

U2 - 10.1038/s41591-024-03114-3

DO - 10.1038/s41591-024-03114-3

M3 - Journal article

C2 - 38977913

AN - SCOPUS:85197684308

SN - 1078-8956

VL - 30

SP - 2020

EP - 2029

JO - Nature Medicine

JF - Nature Medicine

ER -