# Gecombineerde pulsed field-ablatie en linker-atriumoorsluiting: haalbaarheid en uitkomsten

*geplaatst 2026-02-03 · Atriumfibrilleren · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · doi 10.1093/europace/euag017 · https://hartvaat.nl/2026/02/03/gecombineerde-pulsed-field-ablatie-en-linker-atriumoorsluiting-haalbaarheid-en-u/*

Gecombineerde pulsed field-ablatie voor atriumfibrilleren met linker-atriumoorsluiting biedt een eenprocedure-aanpak voor aritmiecontrole en tromboemboliepreventie. Deze prospectieve studie beoordeelde de werkstroom, veiligheid en haalbaarheid in de dagelijkse praktijk.

## English: Feasibility, procedural efficiency, and early imaging outcomes of concomitant pulsed field ablation and left atrial appendage closure: a prospective single-centre study.

This study demonstrated the feasibility and early outcomes of combined pulsed field ablation with LAA closure in a single procedure, offering a one-stop approach for AF rhythm control and stroke prevention.

## Abstract (original, from the publication)

AIMS: Concomitant pulsed field ablation (PFA) for atrial fibrillation (AF) with left atrial appendage closure (LAAC) offers a single-procedure approach for arrhythmia control and thromboembolic risk reduction. This study assessed the workflow, safety, and feasibility of combined PFA and LAAC in routine practice. METHODS AND RESULTS: We prospectively analysed patients undergoing zero-fluoroscopy PFA, with low fluoroscopy for LAAC. Pre-procedural planning used CT imaging and AI-based models for device selection and landing-zone assessment. A single transseptal puncture facilitated intracardiac echocardiography, PFA catheter, and LAAC sheath. A total of 209 patients were included (56% male; mean age 76.5 ± 7.8 years), with 59.3% paroxysmal AF, 40.7% persistent AF, and 50% de novo AF. The mean CHA2DS2-VASc score was 4.5. Mean procedure and left atrial dwell times were 57.3 ± 17 and 45.1 ± 13.6 min, respectively; fluoroscopy averaged 3.4 ± 0.8 min for LAAC. A single LAAC device was used in 94% of cases, achieving adequate seal in all. No pericardial effusion, phrenic nerve injury, kidney, or oesophageal injury occurred; two patients had minor groin bleeding. All were discharged same day on oral anticoagulation for 90 days. Follow-up CT (80%) or TEE (20%) at 111.6 ± 16.5 days showed no leaks >2 mm, a 4.7% small-leak rate, and two device-related thrombi without stroke, managed with extended anticoagulation. CONCLUSION: Combined PFA and LAAC is feasible and safe with favourable early outcomes. Multi-centre studies are warranted to confirm findings and standardize this workflow for broader clinical adoption.

Auteurs: Brandon Doty, Mohamed Mraiyan, Ganesh Nair, Momin Khan, Kirollos Gabrah, Devi G Nair

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Bron: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, https://doi.org/10.1093/europace/euag017. Bijgewerkt 2026-07-03T18:38:13Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.