PFA Changes the Game and the AT Circuit | JACC Baran

Hosts Mitsuaki Sawano, MD, and Hiroyuki Sato, MD, welcome Kazutaka Nakasone, MD (Kobe University) to discuss his JACC: Clinical Electrophysiology study on atrial tachycardia (AT) after pulsed field ablation (PFA) for atrial fibrillation. In a 5-center European registry of 4,144 patients, 76 (1.8%) underwent repeat ablation for AT. Most ATs were left atrial macroreentrant tachycardias, with approximately 86% involving dual-loop circuits. The episode explores why comprehensive left atrial mapping may be key to selecting the optimal ablation line, the impact of PVI versus posterior wall isolation, and the potential role of 3D mapping. Dr. Nakasone also shares how the study grew from his fellowship in Brussels and his experience training in Belgium.