{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:15:44Z","timestamp":1792127744703,"version":"4.4.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016242","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Initial clinical studies of pulsed field ablation (PFA) to treat atrial fibrillation (AF) indicated a &amp;gt;90% durability rate of pulmonary vein isolation (PVI). However, these studies were largely conducted in single centres and involved a limited number of operators. We aimed to describe the electrophysiological findings and outcomes in patients undergoing repeat ablation after an initial PF ablation for AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In the MANIFEST-REDO study, we investigated patients who underwent repeat ablation due to clinical recurrence\u2014AF or atrial tachycardia (AT)\u2014following first-ever PVI with a pentaspline PFA catheter (Farawave, Boston Scientific Inc.). At 22 centres, 427 patients (age 64 \u00b1 11 years; 37% female) were included. Of note, the recurrent arrhythmia leading to the repeat ablation was paroxysmal AF (51%), persistent AF (30%), or AT (19%). At the repeat procedure, the PV reconnection rates were 30% (left superior pulmonary vein), 28% (left inferior pulmonary vein), 33% (right superior pulmonary vein), and 32% (right inferior pulmonary vein). In 45% of patients, all PVs were durably isolated at the beginning of the repeat procedure, with the previous use of any imaging or mapping modality being univariately associated with durable PVI. After a post-redo follow-up period of 284 (90\u2013366) days, the primary effectiveness endpoint (freedom from documented AF\/AT lasting \u226530\u2005s after 3-month blanking without class I\/III antiarrhythmic drugs or symptoms) was achieved in 65% of patients, with significant differences between groups (PAF 65% vs. PersAF 56% vs. AT 76%; P = 0.04). Persistent AF as recurrent arrhythmia after the initial PFA ablation predicted AT\/AF recurrence after repeat ablation [hazard ratio 1.241 (95% confidence interval 1.534\u20131.005); P = 0.045]. The procedural complication rate was 2.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In repeat procedures for AF\/AT performed after an index procedure with PFA for AF, PV reconnections are not uncommon. Repeat procedures can be performed safely and with an acceptable subsequent success rate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euaf012","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T06:24:06Z","timestamp":1737095046000},"source":"Crossref","is-referenced-by-count":74,"title":["Repeat procedures after pulsed field ablation for atrial fibrillation:\n                    <i>MANIFEST-REDO<\/i>\n                    study"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5868-5493","authenticated-orcid":false,"given":"Daniel","family":"Scherr","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8183-8443","authenticated-orcid":false,"given":"Mohit K","family":"Turagam","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4800-1841","authenticated-orcid":false,"given":"Philippe","family":"Maury","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Rangueil , Toulouse ,","place":["France"]},{"name":"I2MC, INSERM UMR 1297 , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Blaauw","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Groningen, University Medical Center Groningen , Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0927-3406","authenticated-orcid":false,"given":"Pepijn","family":"van der Voort","sequence":"additional","affiliation":[{"name":"Catharina Hospital , Eindhoven ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4334-8165","authenticated-orcid":false,"given":"Petr","family":"Neuzil","sequence":"additional","affiliation":[{"name":"Cardiology Department, Na Homolce Hospital, Homolka Hospital , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7197-8415","authenticated-orcid":false,"given":"Tobias","family":"Reichlin","sequence":"additional","affiliation":[{"name":"Inselspital\u2014Bern University Hospital, University of Bern , Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-6396","authenticated-orcid":false,"given":"Andreas","family":"Metzner","sequence":"additional","affiliation":[{"name":"University Heart & Vascular Center, University Medical Center Hamburg-Eppendorf , Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4928-4836","authenticated-orcid":false,"given":"Johan","family":"Vijgen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jessa Hospitals , Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-6182","authenticated-orcid":false,"given":"Josef","family":"Kautzner","sequence":"additional","affiliation":[{"name":"IKEM-Institute for Clinical and Experimental Medicine , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-7042","authenticated-orcid":false,"given":"Serge","family":"Boveda","sequence":"additional","affiliation":[{"name":"Heart Rhythm Department, Clinique Pasteur , Toulouse 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,","place":["Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-309X","authenticated-orcid":false,"given":"Martin","family":"Ruwald","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev-Gentofte University Hospital , Hellerup ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1991-9899","authenticated-orcid":false,"given":"Anna-Sophie","family":"Eberl","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Medical University of Graz , Auenbruggerplatz 15, 8036 Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0490-5862","authenticated-orcid":false,"given":"Christian","family":"Sohns","sequence":"additional","affiliation":[{"name":"Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-University Bochum 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