This is a single-center, prospective, matched cohort study comparing the effect of Pulsed Field Ablation (PFA) versus Radiofrequency Ablation (RF) on postoperative gastric motility in patients with persistent atrial fibrillation (AF). A total of 20 patients will be enrolled in a 1:1 matched design (10 PFA, 10 RF), matched by age, gender, left atrial diameter, AF duration, and diabetes history. All patients will undergo pulmonary vein isolation (PVI) plus left atrial posterior wall isolation (LAPWI).
The primary outcome is gastric emptying assessed by radionuclide imaging preoperatively and at 48 hours post-ablation. Secondary outcomes include gastrointestinal symptom scores: PAGI-SYM, GSRS, and GerdQ measured before ablation and at 7 days post-procedure.
Patients with prior AF ablation, upper gastrointestinal surgery, gastroparesis, or recent use of gastrointestinal medications are excluded. The study period is from January 30, 2026 to July 30, 2026.
This study aims to evaluate whether PFA is associated with better gastric motility preservation compared with conventional RF ablation in persistent AF patients undergoing extended PVI plus posterior wall isolation.
Age 18-80 years
Diagnosed with persistent atrial fibrillation (AF) according to current guidelines
Undergoing first-time catheter ablation (PFA or RF) with planned pulmonary vein isolation plus left atrial posterior wall isolation
Able to understand and sign informed consent
Previous AF ablation or cardiac surgery
History of gastroparesis or severe gastrointestinal disease
Prior upper gastrointestinal surgery
Use of prokinetic or antisecretory medications within 4 weeks before enrollment
Patients with persistent atrial fibrillation aged 18-80 years, scheduled for first-time catheter ablation (pulsed field or radiofrequency) with pulmonary vein isolation plus left atrial posterior wall isolation at a single center. The study aims to compare postoperative gastric motility between the two ablation modalities.
Cohort
Prospective
Pulsed Field Ablation
Procedure/SurgeryPulmonary vein Description isolation combined with left atrial posterior wall isolation using pulsed field ablation for persistent atrial fibrillation.
Radiofrequency Ablation
Procedure/SurgeryPulmonary vein Description isolation combined with left atrial posterior wall isolation using radiofrequency ablation for persistent atrial fibrillation.
Gastric Motility After Pulsed Field Versus Radiofrequency Ablation
Gastric emptying function will be assessed by radionuclide gastric emptying scintigraphy. The primary outcome is the difference in the percentage of gastric retention at 2 hours postprandial between the pulsed field ablation (PFA) group and the radiofrequency ablation (RF) group, measured preoperatively and at 48 hours post-ablation.
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