{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T12:08:59Z","timestamp":1784808539633,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about the efficacy and safety of pulsed field ablation (PFA) for repeat ablation procedures for patients with recurrent atrial fibrillation (AF) after pulmonary vein (PV) isolation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate and compare the efficacy and safety of PFA using a pentaspline ablation catheter with radiofrequency ablation (RFA) in repeat ablation procedures for atrial arrhythmia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We compared 320 patients (mean age 71\u2009\u00b1\u200911 years, 61% male) who underwent repeat ablation procedures with PFA and RFA. Procedural data, including lesion set\u2010specific acute success, safety endpoints, and recurrence of atrial arrhythmia were compared between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 200 and 120 patients were treated with PFA and RFA during repeat ablation, respectively. Although the rate of baseline PV reconnection was comparable between groups, PV, posterior wall, and superior vena cava ablation were targeted in significantly more patients in the PFA group compared to the RFA group. In the PFA group, PV, posterior wall, and superior vena cava isolation were successfully achieved by PFA alone in 100% cases. Adjunctive RFA was required in 31% of anterior wall and 50% of lateral mitral isthmus PFA cases to achieve line of block. Procedure times were significantly shorter in the PFA group. Major complication rates were comparable between the groups (PFA vs. RFA, 0% vs. 1.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.067). Freedom from atrial arrhythmia recurrence at 1 year was similar between PFA and RFA groups (59% vs. 56%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.71).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Use of PFA with a pentaspline catheter for repeat AF ablation was associated with more extensive ablation compared to RFA with low complication rates but did not result in increased freedom from AF recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70458","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T11:58:22Z","timestamp":1784807902000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Pulsed Field Ablation During Repeat Procedures for Treatment of Recurrent Atrial Arrhythmias After Pulmonary Vein Isolation"],"prefix":"10.1111","author":[{"given":"Hiroshi","family":"Miyama","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McCoy","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3461-505X","authenticated-orcid":false,"given":"James E.","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erden","family":"Goljo","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-8305","authenticated-orcid":false,"given":"George","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Markowitz","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce B.","family":"Lerman","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-9360","authenticated-orcid":false,"given":"Jim W.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Cardiology Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"issue":"5","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1056\/NEJMoa1707855","article-title":"Catheter Ablation for Atrial Fibrillation With Heart Failure","volume":"378","author":"Marrouche N. F.","year":"2018","journal-title":"New England Journal of Medicine"},{"issue":"14","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1056\/NEJMoa2019422","article-title":"Early Rhythm\u2010Control Therapy in Patients With Atrial Fibrillation","volume":"383","author":"Kirchhof P.","year":"2020","journal-title":"New England Journal of Medicine"},{"issue":"8","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.amjcard.2020.01.016","article-title":"Meta\u2010Analysis Comparing Cryoballoon Versus Radiofrequency as First Ablation Procedure for Atrial Fibrillation","volume":"125","author":"Fortuni F.","year":"2020","journal-title":"American Journal of Cardiology"},{"issue":"4","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.hrthm.2023.12.003","article-title":"Repeat Catheter Ablation for Atrial Fibrillation","volume":"21","author":"Brahier M. S.","year":"2024","journal-title":"Heart Rhythm"},{"issue":"8","key":"e_1_2_10_6_1","first-page":"987","article-title":"Ablation of Atrial Fibrillation With Pulsed Electric Fields","volume":"4","author":"Reddy V. Y.","year":"2018","journal-title":"JACC: Clinical Electrophysiology"},{"issue":"19","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1422","DOI":"10.1161\/CIRCULATIONAHA.123.063988","article-title":"Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial","volume":"147","author":"Verma A.","year":"2023","journal-title":"Circulation"},{"issue":"18","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1056\/NEJMoa2307291","article-title":"Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation","volume":"389","author":"Reddy V. Y.","year":"2023","journal-title":"New England Journal of Medicine"},{"issue":"2","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jacc.2025.10.051","article-title":"Multicenter Study on the Safety of Pulsed Field Ablation in Over 40,000 Patients","volume":"87","author":"Turagam M. K.","year":"2026","journal-title":"Journal of the American College of Cardiology"},{"issue":"4","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation","volume":"26","author":"Tzeis S.","year":"2024","journal-title":"Europace"},{"issue":"1","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar J. A.","year":"2024","journal-title":"Circulation"},{"issue":"13","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1001\/jama.2019.0693","article-title":"Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial","volume":"321","author":"Packer D. L.","year":"2019","journal-title":"Journal of the American Medical Association"},{"issue":"18","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"2200","DOI":"10.1161\/CIRCULATIONAHA.112.109330","article-title":"Outcomes of Medicare Beneficiaries Undergoing Catheter Ablation for Atrial Fibrillation","volume":"126","author":"Piccini J. P.","year":"2012","journal-title":"Circulation"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"754","article-title":"Progression of Atrial Fibrillation After a Failed Initial Ablation Procedure in Patients With Paroxysmal Atrial Fibrillation: A Randomized Comparison of Drug Therapy Versus Reablation","volume":"6","author":"Pokushalov E.","year":"2013","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"issue":"7","key":"e_1_2_10_15_1","first-page":"1620","article-title":"Impact of Posterior Wall Isolation During AF Ablation on the Incidence of Left Atrial Flutter","volume":"10","author":"Lim M. W.","year":"2024","journal-title":"JACC: Clinical Electrophysiology"},{"issue":"3","key":"e_1_2_10_16_1","article-title":"Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY\u2010PVI Study","volume":"16","author":"Benali K.","year":"2023","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"issue":"7","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1038\/s41591-024-03114-3","article-title":"Safety of Pulsed Field Ablation in More Than 17,000 Patients With Atrial Fibrillation in the MANIFEST\u201017K Study","volume":"30","author":"Ekanem E.","year":"2024","journal-title":"Nature Medicine"},{"issue":"2","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jacc.2025.10.051","article-title":"Multicenter Study on the Safety of Pulsed Field Ablation in Over 40,000 Patients: MANIFEST\u2010US","volume":"87","author":"Turagam M. K.","year":"2026","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/jce.70256","article-title":"Pulsed Field Ablation for the Treatment of Octogenarians With Atrial Fibrillation","volume":"37","author":"Miyama H.","year":"2026","journal-title":"Journal of Cardiovascular Electrophysiology"},{"issue":"1","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae006","article-title":"Posterior Wall Ablation by Pulsed\u2010Field Ablation: Procedural Safety, Efficacy, and Findings on Redo Procedures","volume":"26","author":"Kueffer T.","year":"2023","journal-title":"Europace"},{"issue":"9","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.jacc.2020.07.007","article-title":"Pulsed Field Ablation in Patients With Persistent Atrial Fibrillation","volume":"76","author":"Reddy V. Y.","year":"2020","journal-title":"Journal of the American College of Cardiology"},{"issue":"7","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae160","article-title":"Superior Vena Cava Isolation Using a Pentaspline Pulsed\u2010Field Ablation Catheter: Feasibility and Safety in Patients Undergoing Atrial Fibrillation Catheter Ablation","volume":"26","author":"Ollitrault P.","year":"2024","journal-title":"Europace"},{"issue":"5","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.hrthm.2023.01.009","article-title":"Anterior Mitral Line in Patients With Persistent Atrial Fibrillation and Anterior Scar: A Multicenter Matched Comparison\u2010The MiLine Study","volume":"20","author":"Bergonti M.","year":"2023","journal-title":"Heart Rhythm"},{"issue":"6","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1007\/s10840-022-01436-1","article-title":"Pulsed\u2010Field Ablation for the Treatment of Left Atrial Reentry Tachycardia","volume":"66","author":"Kueffer T.","year":"2023","journal-title":"Journal of Interventional Cardiac Electrophysiology"},{"issue":"1","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1001\/jamacardio.2023.4405","article-title":"Coronary Artery Spasm During Pulsed Field vs Radiofrequency Catheter Ablation of the Mitral Isthmus","volume":"9","author":"Zhang C.","year":"2024","journal-title":"JAMA Cardiology"},{"issue":"10","key":"e_1_2_10_26_1","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae262","article-title":"Cavotricuspid Isthmus Ablation Using a Pentaspline Pulsed Field Ablation Catheter: Feasibility and Acute Results","volume":"26","author":"Chaumont C.","year":"2024","journal-title":"Europace"},{"issue":"2","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1001\/jama.2022.23722","article-title":"Effect of Catheter Ablation Using Pulmonary Vein Isolation With vs Without Posterior Left Atrial Wall Isolation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation: The CAPLA Randomized Clinical Trial","volume":"329","author":"Kistler P. M.","year":"2023","journal-title":"Journal of the American Medical Association"},{"issue":"3","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.hrthm.2020.11.008","article-title":"Epicardial Course of the Septopulmonary Bundle: Anatomical Considerations and Clinical Implications for Roof Line Completion","volume":"18","author":"Pambrun T.","year":"2021","journal-title":"Heart Rhythm"},{"issue":"4","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/jce.12059","article-title":"Macroreentrant Atrial Tachycardia in Patients Without Previous Atrial Surgery or Catheter Ablation: Clinical and Electrophysiological Characteristics of Scar\u2010Related Left Atrial Anterior Wall Reentry","volume":"24","author":"Fukamizu S.","year":"2013","journal-title":"Journal of Cardiovascular Electrophysiology"},{"issue":"3","key":"e_1_2_10_30_1","first-page":"333","article-title":"The Left Atrial Appendage Ostium","volume":"7","author":"Liu C. F.","year":"2021","journal-title":"JACC: Clinical Electrophysiology"},{"issue":"3","key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1093\/europace\/euab216","article-title":"Personalized Paroxysmal Atrial Fibrillation Ablation by Tailoring Ablation Index to the Left Atrial Wall Thickness: The \u2018Ablate by\u2010LAW\u2019 Single\u2010Centre Study\u2010A Pilot Study","volume":"24","author":"Teres C.","year":"2022","journal-title":"EP Europace"},{"issue":"7","key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1093\/eurheartj\/ehi095","article-title":"Where to Draw the Mitral Isthmus Line in Catheter Ablation of Atrial Fibrillation: Histological Analysis","volume":"26","author":"Wittkampf F. H. M.","year":"2005","journal-title":"European Heart Journal"},{"issue":"10","key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1016\/j.hroo.2025.07.002","article-title":"Pulsed\u2010Field Ablation Versus Radiofrequency Ablation in Patients Undergoing Repeat Catheter Ablation for Atrial Fibrillation","volume":"6","author":"Isenegger C.","year":"2025","journal-title":"Heart Rhythm O2"},{"issue":"4","key":"e_1_2_10_34_1","article-title":"Atrial Fibrillation Catheter Ablation Increases the Left Atrial Pressure","volume":"12","author":"Park J.\u2010W.","year":"2019","journal-title":"Circulation: Arrhythmia and Electrophysiology"},{"key":"e_1_2_10_35_1","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.hrthm.2025.12.044","article-title":"Impact of Left Atrial Posterior Wall Isolation Using Pulsed\u2010Field Ablation in Patients Undergoing Repeat Catheter Ablation for Atrial Fibrillation","volume":"23","author":"Badertscher P.","year":"2026","journal-title":"Heart Rhythm"},{"issue":"5","key":"e_1_2_10_36_1","first-page":"900","article-title":"Impact of Left Atrial Posterior Wall Ablation During Pulsed\u2010Field Ablation for Persistent Atrial Fibrillation","volume":"10","author":"Turagam M. 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