{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:12:13Z","timestamp":1793211133914,"version":"4.5.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women are frequently underrepresented in studies investigating atrial fibrillation (AF) ablation. We evaluated the acute efficacy, safety, and mid\u2010term outcomes of de novo paroxysmal AF ablation in female patients using a pentaspline pulsed\u2010field ablation (PFA) versus thermal\u2010based technologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In a cohort of consecutive female patients with paroxysmal AF undergoing de novo pulmonary vein isolation, enrolled in the ATHENA\u2010CHARISMA (Advanced Technologies For Successful Ablation of AF in Clinical Practice \u2010 Catheter Ablation of Arrhythmias With High\u2010DensityMapping System in the Real WorldPractice) registries, thermal ablation systems (radiofrequency or cryoablation) were compared to the PFA by means of a propensity score matching (ratio 1:1:1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      One\u2010thousand one female patients (mean age 63\u00b110\u2009years, mean left ventricular ejection fraction 60.8\u00b16%) were included: 376 (37.6%) underwent cryoablation ablation, 342 (34.2%) radiofrequency ablation, and 283 (28.3%) PFA. Propensity score matching yielded 684 patients (228 per group). The PFA group had significantly shorter skin\u2010to\u2010skin time (60 [50\u201375] minutes) compared with both radiofrequency (120 [90\u2013145] minutes,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and cryoablation (75 [60\u2013100] minutes,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), while fluoroscopy time was similar among groups (15 [11\u201321] minutes for PFA, 14 [10\u201320] minutes for cryoablation,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.599 versus PFA and 14 [9\u201320] minutes for radiofrequency,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.454 versus PFA). Overall complication rate was 3.4% and it was significantly higher after thermal ablation than PFA (4.6% versus 0.9%, OR,\u00a05.5, 95%\u00a0CI, 1.3\u201323.5,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0227). During a median follow\u2010up of 413 [277\u2013589] days, 139 (20.3%) patients experienced AF recurrence. The Kaplan\u2013Meier estimated freedom from AF at 1\u2010year follow\u2010up was 86.8% with PFA, 84.6% with cryoablation, and 83.3% with radiofrequency (log\u2010rank\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      value: 0.839).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among this cohort of female patients, de novo paroxysmal AF using a pentaspline PFA system demonstrated significantly shorter procedural times, and a lower complication rate compared with thermal ablation systems. One\u2010year follow\u2010up revealed comparable rates of AF freedom across all ablation modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      ATHENA (Advanced Technologies For Successful Ablation of AF in Clinical Practice). URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\/\">http:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique identifier: NCT05617456. CHARISMA (Catheter Ablation of Arrhythmias With High\u2010Density Mapping System in the Real World Practice). URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\/\">http:\/\/clinicaltrials.gov\/<\/jats:ext-link>\n                      ; Unique Identifier: NCT03793998.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041873","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:23:23Z","timestamp":1770895403000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["De Novo Pulmonary Vein Isolation by Means of Pulsed Field Versus Conventional Thermal Ablation of Paroxysmal Atrial Fibrillation in Women: Safety, Efficiency, and\u00a0Efficacy"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7319-1632","authenticated-orcid":false,"given":"Valentina","family":"Ribatti","sequence":"first","affiliation":[{"name":"Monzino Cardiological Center, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7737-421X","authenticated-orcid":false,"given":"Antonio","family":"Dello Russo","sequence":"additional","affiliation":[{"name":"Marche University Hospital","place":["Ancona, Italy"]},{"name":"Marche Polytechnic University","place":["Ancona, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9278-2817","authenticated-orcid":false,"given":"Stefania","family":"Riva","sequence":"additional","affiliation":[{"name":"Monzino Cardiological Center, IRCCS","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8823-0334","authenticated-orcid":false,"given":"Maurizio","family":"Malacrida","sequence":"additional","affiliation":[{"name":"Boston Scientific","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2307-8105","authenticated-orcid":false,"given":"Stefano","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina \u2010 Gemelli Isola","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Solimene","sequence":"additional","affiliation":[{"name":"Marche Polytechnic University","place":["Ancona, Italy"]},{"name":"Montevergine Clinic","place":["Mercogliano, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-1110","authenticated-orcid":false,"given":"Saverio","family":"Iacopino","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care & Research","place":["Cotignola, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3864-0375","authenticated-orcid":false,"given":"Antonio","family":"De Simone","sequence":"additional","affiliation":[{"name":"S. Michele Clinic","place":["Maddaloni, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Rossillo","sequence":"additional","affiliation":[{"name":"San Bortolo Hospital","place":["Vicenza, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3236-3458","authenticated-orcid":false,"given":"Gemma","family":"Pelargonio","sequence":"additional","affiliation":[{"name":"Istituto di Cardiologia Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]},{"name":"Department of Cardiovascular Sciences, Arrhythmology Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7274-4541","authenticated-orcid":false,"given":"Giulio","family":"Zucchelli","sequence":"additional","affiliation":[{"name":"Second Division of Cardiology, Cardiac\u2010Thoracic\u2010Vascular Department, New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana","place":["Pisa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4157-830X","authenticated-orcid":false,"given":"Ruggero","family":"Maggio","sequence":"additional","affiliation":[{"name":"Degli Infermi Hospital","place":["Rivoli, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Russo","sequence":"additional","affiliation":[{"name":"San Filippo Neri Hospital","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2318-3818","authenticated-orcid":false,"given":"Domenico","family":"Pecora","sequence":"additional","affiliation":[{"name":"Electrophysiology Unit, Cardiology Operating Unit, Fondazione Poliambulanza Hospital","place":["Brescia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7140","authenticated-orcid":false,"given":"Matteo","family":"Bertini","sequence":"additional","affiliation":[{"name":"University of Ferrara, Sant\u2019Anna University Hospital","place":["Ferrara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5124-1196","authenticated-orcid":false,"given":"Stefano","family":"Bandino","sequence":"additional","affiliation":[{"name":"University Hospital","place":["Sassari, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5288-0108","authenticated-orcid":false,"given":"Mario","family":"Volpicelli","sequence":"additional","affiliation":[{"name":"Cardiovascular Diseases and Electrophysiology Unit, S. Maria della Piet\u00e0 Hospital, Nola","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1924-6548","authenticated-orcid":false,"given":"Paolo","family":"Compagnucci","sequence":"additional","affiliation":[{"name":"Marche University Hospital","place":["Ancona, Italy"]},{"name":"Marche Polytechnic University","place":["Ancona, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Galeazzi \u2010 Sant\u2019Ambrogio","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6311-4270","authenticated-orcid":false,"given":"Matteo","family":"Anselmino","sequence":"additional","affiliation":[{"name":"\u201cCitt\u00e0 della Salute e della Scienza\u201d Hospital","place":["Torino, Italy"]},{"name":"University of Torino","place":["Torino, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-1690","authenticated-orcid":false,"given":"Roberto","family":"Rordorf","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Zingarini","sequence":"additional","affiliation":[{"name":"S. 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