{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:13Z","timestamp":1787028613232,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Regional differences in pulsed field ablation (PFA) adoption for pulmonary vein isolation (PVI) with additional posterior wall ablation (PWA) in Asia remains unknown. We hereby report our experience on the safety and efficacy of PFA in AF ablation. Consecutive AF patients who underwent PFA from September 2022 to January 2024 were included. The primary efficacy endpoint was freedom from atrial arrhythmia recurrence after a 90-day blanking period at 12 months. Safety endpoints included 30 days of all-cause death, cardiac tamponade, stroke, myocardial infarction, and heart failure hospitalization. One hundred and one (72.3% males, 79.2% pAF) patients underwent PFA for AF. Thirty-one (30.7%) had structural heart disease with mean LVEF of 57.4 \u00b1 8.1% and CHA2DS2-VASc score of 1.4 \u00b1 1.3. Twenty-nine (28.7%) underwent additional PWA (PVI + PWA) using PFA. PWA was acutely successful in all patients. Patients who underwent PWA were more likely to have persistent AF and require general anesthesia and electroanatomic mapping (all p &lt; 0.05). Total PFA applications for PVI, LA dwell time, procedural time, and fluoroscopy time were similar between the PVI-only and PVI + PWA groups (all p &gt; 0.05). The 1-year atrial arrhythmia recurrence rates were 10% for pAF and 21% for the persistent AF group. The primary efficacy endpoint was not significantly different between the PVI-only and PVI+PWA groups (12-month KM estimates 90.3% [95% CI, 83.3\u201397.3] and 82.8% [95% CI, 68.1\u201397.4], respectively). There were no complications related to PFA use. PFA can be safely, effectively, and efficiently adopted for AF ablation. Additional PWA, if pursued, had similar procedural metrics to the PVI-only strategy without increased complications.<\/jats:p>","DOI":"10.3390\/jcdd11110356","type":"journal-article","created":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T08:25:14Z","timestamp":1730795114000},"page":"356","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pulsed Field Ablation in Atrial Fibrillation: Initial Experience of the Efficacy and Safety in Pulmonary Vein Isolation and Beyond"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0531-934X","authenticated-orcid":false,"given":"Julian Cheong Kiat","family":"Tay","sequence":"first","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4307-5224","authenticated-orcid":false,"given":"Jannah Lee","family":"Tarranza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaw Yang","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan Ming","family":"Pung","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germaine Jie Min","family":"Loo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooi Khee","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1888-2246","authenticated-orcid":false,"given":"Colin","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Changi, General Hospital, Singapore 529889, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0164-7925","authenticated-orcid":false,"given":"Vern Hsen","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Changi, General Hospital, Singapore 529889, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Tien Siang","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Thuan Tee","family":"Chong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah Leng","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3454-3866","authenticated-orcid":false,"given":"Chi Keong","family":"Ching","sequence":"additional","affiliation":[{"name":"Department of Cardiology, National Heart Centre Singapore, Singapore 169609, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int. 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