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Background <p>Clinical outcomes in females undergoing catheter ablation for atrial fibrillation (AF) have been mixed. Limited real-world data are currently available regarding outcomes in female patients following pulsed field ablation (PFA).</p> Methods <p>We performed an observational study of consecutive patients undergoing PFA with a pentaspline catheter (Farapulse™, Boston Scientific) for AF at a large tertiary centre from 2022 to 2025 in Australia. Baseline demographics, procedural characteristics and clinical outcomes were collected. We compared clinical outcomes in female patients with males. Arrhythmia recurrence was defined as AF, atrial flutter or atrial tachycardia &gt; 30&#xa0;s at any follow-up.</p> Results <p>A total of 564 patients underwent PFA for AF; 196 patients (36.4%) were female. Females were older (median age 66 vs. 62&#xa0;years; <i>p</i> &lt; 0.001), had increased body mass index (29.7 vs. 28.4&#xa0;kg/m<sup>2</sup>; <i>p</i> = 0.02) and more paroxysmal AF (71% vs. 59%; <i>p</i> = 0.03). Median number of PFA applications was higher in males (60 vs. 56 applications; <i>p</i> &lt; 0.01). Procedural and left atrial dwell time were similar between groups; however, females received less radiation exposure (<i>p</i> &lt; 0.001). There were no significant differences in overall major or minor procedural complications between groups, however a trend towards more cardiac tamponade in females (<i>p</i> = 0.052). There was no difference between groups for freedom from arrhythmia recurrence between groups (70.2% both groups at median follow-up 5.3–7.9&#xa0;months).</p> Conclusion <p>Females have similar clinical outcomes with PFA compared with males, thus should be considered for AF ablation for symptomatic AF. Longer term clinical data are needed to evaluate the efficacy of PFA in this cohort.</p> Graphical Abstract <p></p>

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Procedural and clinical outcomes of pulsed field ablation for atrial fibrillation in female patients: an observational study at a large tertiary centre in Australia

  • 期刊论文

  • 发表日期：

    2025年11月19日

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  • Francis J. Ha,
  • Duron Prinsloo,
  • Edwin Xu,
  • Hui Chen Han,
  • Nitesh Nerlekar,
  • Adam J. Brown,
  • Emily Kotschet

摘要

Background

Clinical outcomes in females undergoing catheter ablation for atrial fibrillation (AF) have been mixed. Limited real-world data are currently available regarding outcomes in female patients following pulsed field ablation (PFA).

Methods

We performed an observational study of consecutive patients undergoing PFA with a pentaspline catheter (Farapulse™, Boston Scientific) for AF at a large tertiary centre from 2022 to 2025 in Australia. Baseline demographics, procedural characteristics and clinical outcomes were collected. We compared clinical outcomes in female patients with males. Arrhythmia recurrence was defined as AF, atrial flutter or atrial tachycardia > 30 s at any follow-up.

Results

A total of 564 patients underwent PFA for AF; 196 patients (36.4%) were female. Females were older (median age 66 vs. 62 years; p < 0.001), had increased body mass index (29.7 vs. 28.4 kg/m2; p = 0.02) and more paroxysmal AF (71% vs. 59%; p = 0.03). Median number of PFA applications was higher in males (60 vs. 56 applications; p < 0.01). Procedural and left atrial dwell time were similar between groups; however, females received less radiation exposure (p < 0.001). There were no significant differences in overall major or minor procedural complications between groups, however a trend towards more cardiac tamponade in females (p = 0.052). There was no difference between groups for freedom from arrhythmia recurrence between groups (70.2% both groups at median follow-up 5.3–7.9 months).

Conclusion

Females have similar clinical outcomes with PFA compared with males, thus should be considered for AF ablation for symptomatic AF. Longer term clinical data are needed to evaluate the efficacy of PFA in this cohort.

Graphical Abstract