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Comparative Study of Microembolic Signal Incidence Among Farapulse, PulseSelect, and Varipulse PFA Systems in Atrial Fibrillation Ablation

Sep 12, 2025 20:04 CST Updated 20:04
Farapulse

Atrial Fibrillation Treatment Catheter Tool Manufacturer

In "HeartRhythm》Publish an article aboutDuring the treatment of atrial fibrillation with the three PFA products: FARAPULSE, PulseSelect, and VARIPULSEA Comparative Study on the Incidence of Microembolic Signals (MESs).
Research Methods
This study enrolled 33 patients treated with PFA (11 in the FARAPULSE group, 11 in the PulseSelect group, and 11 in the VARIPULSE group). Carotid ultrasound was continuously used during the procedure to monitor real-time vascular parameters, and brain magnetic resonance imaging was performed the day after the operation. Pulmonary vein isolation was conducted at the ostium and sinus of the pulmonary veins according to the recommended number of energy applications.

Results

  • During pulmonary vein isolation, the number of MESs in the FARAPULSE group was significantly lower than in the PulseSelect group (61±45 vs 472±337, P=0.01) and the VARIPULSE group (61±45 vs 858±266, P<0.001). In all pulmonary vein isolations, the VARIPULSE group generated more MESs than the FARAPULSE group.

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  • During the isolation of the lower pulmonary veins, the VARIPULSE group generated more MESs than the PulseSelect group. Although the PulseSelect group had a higher incidence of MESs during the isolation of the left upper pulmonary vein, the count of MESs decreased during the subsequent isolation of the three pulmonary veins.

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  • In the VARIPULSE group, 4 patients (36%) experienced multiple SCEs/SCLs, while in the FARAPULSE group, only 1 patient experienced an SCE. No SCEs/SCLs were observed in the PulseSelect group.

Conclusion

The incidence of MESs during VARIPULSE procedures was significantly higher than that during FARAPULSE procedures. PulseSelect generated the most MESs during the initial energy delivery phase. Multiple SCEs/SCLs were only observed with VARIPULSE.