Study population

At the time of the analysis, PEFCAT had enrolled 50 patients at Homolka Hospital with symptomatic paroxysmal atrial fibrillation (PAF) resistant to antiarrhythmic medications, a left ventricular ejection fraction >40%, and left atrial (LA) anteroposterior dimension <5.0 cm. There were no exclusions for PV anatomy. From this 50-patient cohort, 45 underwent protocol pre-specified invasive PV reassessment at ∼75 days after the index procedure.

Regarding the thermal ablation cohort, 204 consecutive patients with PAF underwent redo ablation for AF recurrence between April 2015 to August 2020. All patients were referred to the Icahn School of Medicine at Mount Sinai for electrophysiological evaluation and catheter ablation. We excluded patients with (i) any PV reconnections, (ii) prior additional ablation such as roof line ablation, LA posterior wall ablation, or ablation of complex fractionated atrial electrograms, and (iii) previous multiple AF ablation sessions.

We compared the PVI areas: (i) of the PFA cohort with the thermal ablation cohort, (ii) between the PFA, RFA, and Balloon ablation cohorts, and (iii) between the PFA and RFA cohorts after propensity score matching of patient characteristics.