ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1627579
This article is part of the Research TopicCardioimmunology and Arrhythmias: Mechanism, Diagnosis and Novel TherapyView all 5 articles
Higher Premature Atrial Contraction Burden after Radiofrequency Ablation versus Pulsed Field or Cryoballoon Ablation in Paroxysmal Atrial Fibrillation: A Three-year Follow-up Retrospective Study
Provisionally accepted
Yongxing Jiang
Chenxu LuoMingjun Feng
Yibo Yu
Xianfeng Du
Caijie Shen
Guohua Fu
Binhao WangRenyuan Fang
He JinFang Gao
Huimin Chu*- the First Affiliated Hospital of Ningbo University, Ningbo, China
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Background Pulsed field ablation (PFA), as a novel non-thermal energy source, has shown favorable one-year data on efficacy and safety profile in treatment of paroxysmal atrial fibrillation (PAF). We sought to compare PFA, cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in PAF treatment in a three-year follow-up period. Methods Patients with PAF undergoing the first-time catheter ablation by PFA, CBA and RFA were retrospectively included. The procedure endpoint was pulmonary vein isolation (PVI). Patients were followed with 24-hour ambulatory ECG monitoring at the 1, 3, 6, 12 months and every 6 months thereafter. The primary efficacy endpoint was freedom from any atrial tachyarrhythmia > 30 seconds occurring after the 3-month blanking period. Results A total of 280 PAF patients ablated either by PFA (n=65), CBA (n=55), or RFA (n=160) were enrolled. The mean age was 60.9 ± 8.7 years, with 55.7% male patients (n=156). Acute PVI was achieved in all patients. Total procedural time was shortest with PFA [91.0 (85.0, 103.0) min, P<0.001), whereas fluoroscopy time was shortest with RFA [9.0 (7.0, 10.0) min, P<0.001). Peri-procedural complication rates were 2.5%. The Kaplan-Meier estimated three-year freedom from any atrial tachyarrhythmia > 30 seconds was 76.9% with PFA, 72.7% with CBA, and 66.9% with RFA (log-rank P=0.298). The principle finding of study was the significantly lowest premature atrial contraction (PAC) burden in non-recurrent patients treated with PFA (0.04%) compared to CBA (0.05%) and RFA (0.11%) (P<0.001). Conclusion In the three-year follow-up, arrhythmia freedom was similar in PFA, CBA and
Keywords: Premature atrial contraction, Paroxysmal atrial fibrillation, pulsed field ablation, Cryoballoon ablation, Radiofrequency ablation
Received: 13 May 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Jiang, Luo, Feng, Yu, Du, Shen, Fu, Wang, Fang, Jin, Gao and Chu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huimin Chu, the First Affiliated Hospital of Ningbo University, Ningbo, China
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