Both 31 mm and 35 mm pentaspline pulsed-field ablation (PFA) catheters achieved comparable safety and efficacy in patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation (AF), according to a prospective registry study presented at the European Society of Cardiology Congress 2025.

The analysis included 360 patients (median age 68 years; 29% female) treated between January 2022 and November 2024. Participants were matched by age, sex, AF type, and cardiovascular risk factors. Among them, 67% underwent ablation using the 31 mm system and 33% with the 35 mm system.

The total procedure duration was slightly shorter with the 35 mm catheter (48 vs 54 minutes; p=0.033), while fluoroscopy and left atrial dwell times were similar between groups. Recurrence-free survival at a median 225-day follow-up was nearly identical—76% in the 31 mm group and 78% in the 35 mm group (p=0.510).

These results indicate that both catheter sizes offer equivalent procedural performance and rhythm control, supporting flexible clinical use based on operator preference and patient anatomy.