The Lead Episode 138: A Discussion of Safety, Efficacy, and Mid-Term Outcomes of Pulsed Field Ablation for Cavotricuspid Isthmus–Dependent Flutter: Real-World Data From a Major Health System Registry-The Lead Episode 138 Speaker Information

The Lead Episode 138 Speaker Information

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The article under discussion, published in Circulation: Arrhythmia and Electrophysiology, examines the safety, efficacy, and mid-term outcomes of pulsed field ablation (PFA) for treating cavotricuspid isthmus–dependent atrial flutter using real-world registry data from a major health system. The study is authored by Juan F. Rodriguez-Riascos, MD, and colleagues.<br /><br />Pulsed field ablation is an emerging, non-thermal ablation technique that selectively targets myocardial tissue while sparing adjacent structures, potentially offering advantages over conventional radiofrequency or cryoablation methods. This study analyzed patient data to assess procedural success rates, complication profiles, and arrhythmia recurrence over a mid-term follow-up period, reflecting everyday clinical practice outside controlled trials.<br /><br />The discussion was hosted by Deep Chandh Raja, MBBS, MD, PhD from the Australian National University and Kauvery Hospital, with contributions from experts Lee Karl Thien, MD, CCDS (National Heart Institute), and Senthil Thambidorai, MD, FHRS (Texas Cardiac Arrhythmia). Notably, none of the hosting or contributing physicians declared any conflicts of interest.<br /><br />Overall, the registry data appear to support PFA as a safe and effective approach for cavotricuspid isthmus–dependent flutter, demonstrating favorable mid-term outcomes comparable or superior to established ablation techniques. The real-world evidence strengthens the clinical adoption of PFA, highlighting its potential to minimize complications while maintaining efficacy in typical patient populations. This discussion serves to inform electrophysiologists and cardiologists about evolving ablation strategies and encourages further research to consolidate long-term benefits of pulsed field ablation in atrial flutter management.

Keywords

pulsed field ablation

cavotricuspid isthmus

atrial flutter

arrhythmia treatment

non-thermal ablation

real-world registry data

mid-term outcomes

procedural safety

efficacy

electrophysiology