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The Lead Episode 10: A Discussion of Pulsed Field Ablation for the Treatment of Atrial Fibrillation - PULSED AF Pivotal Trial
William H. Sauer, MD, FHRS, CCDS, is joined by guests Nathaniel Steiger, MD, and Paul C. Zei, MD, PhD, FHRS, for a discussion on the PULSED AF Pivotal Trial. This was a prospective, global, multicenter, nonrandomized, paired single-arm study in which patients with paroxysmal (n=150) or persistent (n=150) symptomatic atrial fibrillation (AF) refractory to class I or III antiarrhythmic drugs were treated with pulsed field ablation. The results demonstrate similar efficacy compared with clinical studies evaluating radiofrequency ablation and cryothermal ablation. Safety with the new form of ablation technology appeared to be promising with no evidence of esophageal injury or phrenic nerve palsy observed.
Learning Objectives
  • To recognize irreversible electroporation as a novel, nonthermal method for cardiac ablation.
  • To understand the methods and results of the PULSED-AF trial.
  • To distinguish the advantages and disadvantages of pulsed field ablation over traditional radiofrequency or cryoablation technologies for pulmonary vein isolation.
Article Authors and Podcast Contributors
Article Authors
Atul Verma, David E. Haines, Lucas V. Boersma, Nitesh Sood, Andrea Natale, Francis E. Marchlinski, Hugh Calkins, Prashanthan Sanders, Douglas L. Packer, Karl-Heinz Kuck, Gerhard Hindricks, Birce Onal, Jeffrey Cerkvenik, Hiroshi Tada, David B. DeLurgio on behalf of the PULSED AF Investigators

Podcast Contributors
William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital

Nathaniel Steiger, MD, of Brigham and Women's Hospital
Paul C. Zei, MD, PhD, FHRS, of Brigham and Women's Hospital
Disclosure Policy

ACE Disclosure Policy

The Heart Rhythm Society is committed to the provision of Accredited Continuing Education (formerly known as Continuing Medical Education (CME)) that is balanced, objective, and evidence based. HRS adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME) which require that those individuals in a position to control the content of an educational activity (including, but not limited to, planners, faculty, authors, committee members, content reviewers, editors, and staff) disclose all financial relationships with an ACCME-defined ineligible company* within the 24 months prior to the disclosure.


Any individual who refuses to disclose financial relationships is disqualified from participating in HRS ACE-certified activities. Owners and employees of ACCME-defined ineligible companies may have no role in the planning or implementation of ACE activities without a special written exemption from the HRS Chief Learning Officer that will be granted only in specific circumstances that meet ACCME requirements.

ACCME Definition:

*An ineligible company is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Examples of such organizations include:

  • Advertising, marketing, or communication firms whose clients are ineligible companies
  • Bio-medical startups that have begun a governmental regulatory approval process
  • Compounding pharmacies that manufacture proprietary compounds
  • Device manufacturers or distributors
  • Diagnostic labs that sell proprietary products
  • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
  • Manufacturers of health-related wearable products
  • Pharmaceutical companies or distributors
  • Pharmacy benefit managers
  • Reagent manufacturers or sellers


All relevant financial relationships have been mitigated.

Host Disclosure(s):
W. Sauer: Honoraria/Speaking/Consulting Fee: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific; Research (Contracted Grants for PIs Named Investigators Only): Medtronic

Contributor Disclosure(s):
N. Steiger: No relevant financial relationships with ineligible companies to disclose.
P. Zei: Honoraria/Speaking/Consulting: Varian Medical Systems, Biosense Webster, Inc., Abbott; Research (Contracted Grants for PIs Named Investigators Only): Biosense Webster, Inc.; Stocks (Publicly Traded): Affera, Inc.

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
J. Glenn: No relevant financial relationships with ineligible companies to disclose. 
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Availability: On-Demand
Cost: FREE
Credit Offered:
No Credit Offered
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