Pulsed-field ablation for the treatment of left atrial reentry tachycardia.

Kueffer, Thomas; Seiler, Jens; Madaffari, Antonio; Mühl, Aline; Asatryan, Babken; Stettler, Robin; Haeberlin, Andreas; Noti, Fabian; Servatius, Helge; Tanner, Hildegard; Baldinger, Samuel H; Reichlin, Tobias; Roten, Laurent (2023). Pulsed-field ablation for the treatment of left atrial reentry tachycardia. Journal of interventional cardiac electrophysiology, 66(6), pp. 1431-1440. Springer 10.1007/s10840-022-01436-1

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We describe our initial experience using a multipolar pulsed-field ablation catheter for the treatment of left atrial (LA) reentry tachycardia.


We included all patients with LA reentry tachycardia treated with PFA at our institution between September 2021 and March 2022. The tachycardia mechanism was identified using 3D electro-anatomical mapping (3D-EAM). Subsequently, a roof line, anterior line, or mitral isthmus line was ablated as appropriate. Roof line ablation was always combined with LA posterior wall (LAPW) ablation. Positioning of the PFA catheter was guided by a 3D-EAM system and by fluoroscopy. Bidirectional block across lines was verified using standard criteria. Additional radiofrequency ablation (RFA) was used to achieve bidirectional block as necessary.


Among 22 patients (median age 70 (59-75) years; 9 females), we identified 27 LA reentry tachycardia: seven roof dependent macro-reentries, one posterior-wall micro-reentry, twelve peri-mitral macro-reentries, and seven anterior-wall micro-reentries. We ablated a total of 20 roof lines, 13 anterior lines, and 6 mitral isthmus lines. Additional RFA was necessary for two anterior lines (15%) and three mitral isthmus lines (50%). Bidirectional block was achieved across all roof lines, 92% of anterior lines, and 83% of mitral isthmus lines. We observed no acute procedural complications.


Ablation of a roof line and of the LAPW is feasible, effective, and safe using this multipolar PFA catheter. However, the catheter is less suited for ablation of the mitral isthmus and the anterior line. A focal pulsed-field ablation catheter may be more effective for ablation of these lines. This study shows the feasibility to ablate linear lesions with a multipolar pulsed-field ablation catheter. 27 left atrial reentry tachycardia were treated in 22 patients.

Item Type:

Journal Article (Original Article)


10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Musculoskeletal Biomechanics
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Kueffer, Thomas, Seiler, Jens, Madaffari, Antonio, Mühl, Aline, Asatryan, Babken, Häberlin, Andreas David Heinrich, Noti, Fabian, Servatius, Helge Simon (B), Tanner, Hildegard, Baldinger, Samuel Hannes, Reichlin, Tobias Roman, Roten, Laurent


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

12 Dec 2022 10:16

Last Modified:

26 Aug 2023 00:11

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Uncontrolled Keywords:

3D mapping Anterior line Electroporation Mitral isthmus Pulsed field ablation Reentry tachycardia Roof line





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