{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:43:28Z","timestamp":1780670608400,"version":"3.54.1"},"reference-count":26,"publisher":"Becaris Publishing Limited","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    Pulsed field ablation (PFA) is a minimally thermal alternative to traditional thermal catheter ablation for atrial fibrillation (AF), with comparable efficacy and minimal risk of collateral tissue injury. Three-dimensional (3D) electroanatomical mapping systems have been adopted with nonintegrated PFA catheters to improve precision and procedural efficiency. This study compared arrhythmia-related hospital readmissions and procedure-related complications among patients with AF treated with PFA, using either the CARTO\u2122 3 or EnSite\u2122 electroanatomical mapping system.\n                    <jats:bold>Materials &amp; methods:<\/jats:bold>\n                    Patients who underwent PFA for AF using nonintegrated pulsed field catheters with either CARTO 3 or EnSite were identified from the 2023\u20132024 Premier Healthcare Database (PHD). The primary outcome was 30-day inpatient readmission and emergency room (ER) visit for AF\/atrial flutter (AFL)\/atrial tachycardia following the index PFA procedure. Secondary outcomes included 30-day cardiovascular-related readmissions and procedure-related complications. Cohorts were balanced using inverse probability of treatment weighting. Descriptive analyses and a weighted Generalized Estimating Equation (GEE) model were used to assess differences in outcomes between groups.\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 2894 patients were treated using CARTO 3 and 2015 using EnSite. After weighting, patient and hospital characteristics were well balanced across cohorts. The CARTO 3 group was significantly less likely to experience AF\/AFL\/atrial tachycardia-related readmissions (0.3% vs 0.9%, chi-square p\u00a0=\u00a00.023; odds ratio [OR], 0.39; 95% CI, 0.17\u20130.90, GEE p\u00a0=\u00a00.028) and a composite outcome of AF\/AFL\/atrial tachycardia-related inpatient readmission or ER visits (0.5% vs 1.1%, chi-square p = 0.020; OR: 0.44, 95% CI: 0.21\u20130.89, GEE p = 0.023) within 30\u00a0days of PFA procedure than the EnSite group. No differences were observed in cardiovascular-related readmission or complications.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    In this retrospective, real-world study, patients with AF who underwent PFA using CARTO 3 had lower 30-day AF\/AFL\/atrial tachycardia-related readmissions rates than those treated with EnSite suggesting that choice of mapping system may influence early AF outcomes and could translate into reduced downstream hospitalizations and resource use.\n                  <\/jats:p>","DOI":"10.57264\/cer-2025-0151","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T15:21:17Z","timestamp":1767885677000},"source":"Crossref","is-referenced-by-count":1,"title":["Difference in hospital readmission among patients with atrial fibrillation undergoing ablation using nonintegrated pulsed field catheter with CARTO\u2122 3 versus EnSite\u2122 electroanatomical mapping system"],"prefix":"10.57264","volume":"15","author":[{"given":"Alexandru I","family":"Costea","sequence":"first","affiliation":[{"name":"The Christ Hospital Cincinnati, Cincinnati, OH 45219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Khanna","sequence":"additional","affiliation":[{"name":"MedTech Epidemiology &amp; Real-World Data Science, Johnson &amp; Johnson, New Brunswick, NJ 08933, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson MedTech, Franchise Health Economics &amp; Market Access, Irvine, CA 92618, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8571-3872","authenticated-orcid":false,"given":"Yiran","family":"Rong","sequence":"additional","affiliation":[{"name":"MedTech Epidemiology &amp; Real-World Data Science, Johnson &amp; Johnson, New Brunswick, NJ 08933, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"issue":"18","key":"e_1_3_8_2_2","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1001\/jama.285.18.2370","article-title":"Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study","volume":"285","author":"Go AS","year":"2001","unstructured":"Go AS, Hylek EM, Phillips KA Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 285(18), 2370\u20132375 (2001).","journal-title":"JAMA"},{"issue":"10","key":"e_1_3_8_3_2","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1161\/CIR.0000000000000659","article-title":"Heart disease and stroke statistics-2019 update: a report from the American Heart Association","volume":"139","author":"Benjamin EJ","year":"2019","unstructured":"Benjamin EJ, Muntner P, Alonso A Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation 139(10), e56\u2013e528 (2019).","journal-title":"Circulation"},{"issue":"9","key":"e_1_3_8_4_2","doi-asserted-by":"crossref","first-page":"e007414","DOI":"10.1161\/CIRCEP.119.007414","article-title":"Catheter ablation versus medical therapy for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Asad ZUA","year":"2019","unstructured":"Asad ZUA, Yousif A, Khan MS, Al-Khatib SM, Stavrakis S. Catheter ablation versus medical therapy for atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. Circ. Arrhythm. Electrophysiol. 12(9), e007414 (2019).","journal-title":"Circ. Arrhythm. Electrophysiol."},{"issue":"13","key":"e_1_3_8_5_2","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1001\/jama.2019.0692","article-title":"Effect of catheter ablation vs medical therapy on quality of life among patients with atrial fibrillation: the CABANA randomized clinical trial","volume":"321","author":"Mark DB","year":"2019","unstructured":"Mark DB, Anstrom KJ, Sheng S Effect of catheter ablation vs medical therapy on quality of life among patients with atrial fibrillation: the CABANA randomized clinical trial. JAMA 321(13), 1275\u20131285 (2019).","journal-title":"JAMA"},{"issue":"5","key":"e_1_3_8_6_2","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 NF","year":"2018","unstructured":"Marrouche NF, Brachmann J, Andresen D Catheter ablation for atrial fibrillation with heart failure. N. Engl. J. Med. 378(5), 417\u2013427 (2018).","journal-title":"N. Engl. J. Med."},{"issue":"14","key":"e_1_3_8_7_2","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1161\/CIRCULATIONAHA.120.050991","article-title":"Ablation versus drug therapy for atrial fibrillation in heart failure: results from the CABANA trial","volume":"143","author":"Packer DL","year":"2021","unstructured":"Packer DL, Piccini JP, Monahan KH Ablation versus drug therapy for atrial fibrillation in heart failure: results from the CABANA trial. Circulation 143(14), 1377\u20131390 (2021).","journal-title":"Circulation"},{"key":"e_1_3_8_8_2","doi-asserted-by":"crossref","first-page":"107871","DOI":"10.1016\/j.bioelechem.2021.107871","article-title":"Cell death due to electroporation - a review","volume":"141","author":"Batista Napotnik T","year":"2021","unstructured":"Batista Napotnik T, Polaj\u017eer T, Miklav\u010di\u010d D. Cell death due to electroporation - a review. Bioelectrochemistry 141, 107871 (2021).","journal-title":"Bioelectrochemistry"},{"issue":"8","key":"e_1_3_8_9_2","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1111\/jce.14414","article-title":"Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation","volume":"31","author":"Bradley CJ","year":"2020","unstructured":"Bradley CJ, Haines DE. Pulsed field ablation for pulmonary vein isolation in the treatment of atrial fibrillation. J. Cardiovasc. Electrophysiol. 31(8), 2136\u20132147 (2020).","journal-title":"J. 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Circulation 147(19), 1422\u20131432 (2023).","journal-title":"Circulation"},{"issue":"6","key":"e_1_3_8_12_2","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1111\/jce.13484","article-title":"Temporal trends in safety and complication rates of catheter ablation for atrial fibrillation","volume":"29","author":"Muthalaly RG","year":"2018","unstructured":"Muthalaly RG, John RM, Schaeffer B Temporal trends in safety and complication rates of catheter ablation for atrial fibrillation. J. Cardiovasc. Electrophysiol. 29(6), 854\u2013860 (2018).","journal-title":"J. Cardiovasc. Electrophysiol."},{"issue":"9","key":"e_1_3_8_13_2","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1007\/s10840-024-01846-3","article-title":"Procedural efficiency is enhanced combining the pentaspline pulsed field ablation catheter with three-dimensional electroanatomical mapping system for pulmonary vein isolation","volume":"67","author":"Falasca Zamponi A","year":"2024","unstructured":"Falasca Zamponi A, Olson J, Scheel S, Englund A, Scorza R, Tabrizi F. Procedural efficiency is enhanced combining the pentaspline pulsed field ablation catheter with three-dimensional electroanatomical mapping system for pulmonary vein isolation. J. Interv. Card. Electrophysiol. 67(9), 1993\u20132001 (2024).","journal-title":"J. Interv. Card. Electrophysiol."},{"issue":"6","key":"e_1_3_8_14_2","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1007\/s10840-022-01436-1","article-title":"Pulsed-field ablation for the treatment of left atrial reentry tachycardia","volume":"66","author":"Kueffer T","year":"2023","unstructured":"Kueffer T, Seiler J, Madaffari A Pulsed-field ablation for the treatment of left atrial reentry tachycardia. J. Interv. Card. Electrophysiol. 66(6), 1431\u20131440 (2023).","journal-title":"J. Interv. Card. Electrophysiol."},{"issue":"3","key":"e_1_3_8_15_2","first-page":"A4","article-title":"A hybrid approach using pulse field ablation and three-dimensional mapping in atrial fibrillation ablation: a relatively early worldwide experience","volume":"108","author":"Mittal A","year":"2022","unstructured":"Mittal A, Hong K, Fitzpatrick N A hybrid approach using pulse field ablation and three-dimensional mapping in atrial fibrillation ablation: a relatively early worldwide experience. Heart 108(Suppl. 3), A4\u2013A6 (2022).","journal-title":"Heart"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.57264\/cer-2024-0075"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.16408"},{"issue":"12","key":"e_1_3_8_18_2","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1111\/jce.16083","article-title":"Early recurrences predict late therapy failure after pulsed field ablation of atrial fibrillation","volume":"34","author":"Plank K","year":"2023","unstructured":"Plank K, Bordignon S, Urbanek L Early recurrences predict late therapy failure after pulsed field ablation of atrial fibrillation. J. Cardiovasc. Electrophysiol. 34(12), 2425\u20132433 (2023).","journal-title":"J. Cardiovasc. 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Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Stat. Med. 34(28), 3661\u20133679 (2015).","journal-title":"Stat. Med."},{"issue":"1","key":"e_1_3_8_22_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.17925\/HI.2024.18.1.3","article-title":"Efficacy of commonly used 3D mapping systems in acute success rates of catheter ablation procedures","volume":"18","author":"Bazoukis G","year":"2024","unstructured":"Bazoukis G, Elkholey K, Stavrakis S, Heist EK, Armoundas AA. Efficacy of commonly used 3D mapping systems in acute success rates of catheter ablation procedures. Heart Int. 18(1), 9\u201325 (2024).","journal-title":"Heart Int."},{"issue":"2","key":"e_1_3_8_23_2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1002\/joa3.12308","article-title":"2019 APHRS expert consensus statement on three-dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS","volume":"36","author":"Kim YH","year":"2020","unstructured":"Kim YH, Chen SA, Ernst S 2019 APHRS expert consensus statement on three-dimensional mapping systems for tachycardia developed in collaboration with HRS, EHRA, and LAHRS. J. Arrhythm. 36(2), 215\u2013270 (2020).","journal-title":"J. Arrhythm."},{"issue":"5","key":"e_1_3_8_24_2","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1159\/000526564","article-title":"Feasibility, efficiency, and safety of zero-fluoroscopy catheter interventions for right-sided cardiac arrhythmias using only electroanatomic mapping","volume":"147","author":"Hofer D","year":"2022","unstructured":"Hofer D, Steffel J, Duru F Feasibility, efficiency, and safety of zero-fluoroscopy catheter interventions for right-sided cardiac arrhythmias using only electroanatomic mapping. Cardiology 147(5\u20136), 547\u2013556 (2022).","journal-title":"Cardiology"},{"issue":"7","key":"e_1_3_8_25_2","doi-asserted-by":"crossref","first-page":"4172","DOI":"10.19102\/icrm.2020.110701","article-title":"Advancements in imaging for atrial fibrillation ablation: is there a potential to improve procedural outcomes?","volume":"11","author":"Obeng-Gyimah E","year":"2020","unstructured":"Obeng-Gyimah E, Nazarian S. Advancements in imaging for atrial fibrillation ablation: is there a potential to improve procedural outcomes? J. Innov. Card. Rhythm. Manag. 11(7), 4172\u20134178 (2020).","journal-title":"J. Innov. Card. Rhythm. Manag."},{"issue":"9","key":"e_1_3_8_26_2","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad211","article-title":"Feasibility of three-dimensional artificial intelligence algorithm integration with intracardiac echocardiography for left atrial imaging during atrial fibrillation catheter ablation","volume":"25","author":"Di Biase L","year":"2023","unstructured":"Di Biase L, Zou F, Lin AN Feasibility of three-dimensional artificial intelligence algorithm integration with intracardiac echocardiography for left atrial imaging during atrial fibrillation catheter ablation. Europace 25(9), euad211 (2023).","journal-title":"Europace"},{"issue":"1","key":"e_1_3_8_27_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s10840-021-01045-4","article-title":"Reconstruction of the left atrium for atrial fibrillation ablation using the machine learning CARTO 3 m-FAM software","volume":"64","author":"Schwartz AL","year":"2022","unstructured":"Schwartz AL, Chorin E, Mann T Reconstruction of the left atrium for atrial fibrillation ablation using the machine learning CARTO 3 m-FAM software. J. Interv. Cardi. Electrophysiol. 64(1), 39\u201347 (2022).","journal-title":"J. Interv. Cardi. Electrophysiol."}],"container-title":["Journal of Comparative Effectiveness Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/becarispublishing.com\/doi\/pdf\/10.57264\/cer-2025-0151","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:15:41Z","timestamp":1770286541000},"score":1,"resource":{"primary":{"URL":"https:\/\/becarispublishing.com\/doi\/10.57264\/cer-2025-0151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.57264\/cer-2025-0151"],"URL":"https:\/\/doi.org\/10.57264\/cer-2025-0151","relation":{},"ISSN":["2042-6305","2042-6313"],"issn-type":[{"value":"2042-6305","type":"print"},{"value":"2042-6313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"article-number":"e250151"}}