{"id":"https://openalex.org/W7207816205","doi":"https://doi.org/10.3390/jcm15176838","title":"Fluoroless Workflow for Pulsed Field Ablation of Atrial Fibrillation Using the Sphere-9 and VARIPULSE Catheters","display_name":"Fluoroless Workflow for Pulsed Field Ablation of Atrial Fibrillation Using the Sphere-9 and VARIPULSE Catheters","publication_year":2026,"publication_date":"2026-09-03","ids":{"openalex":"https://openalex.org/W7207816205","doi":"https://doi.org/10.3390/jcm15176838","pmid":"https://pubmed.ncbi.nlm.nih.gov/42739841","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13565874"},"language":"en","primary_location":{"id":"doi:10.3390/jcm15176838","doi":"https://doi.org/10.3390/jcm15176838","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15176838","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/jcm15176838","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5136111344","display_name":"Rachita Kour","orcid":"https://orcid.org/0009-0008-8637-2708","observed_orcids":["https://orcid.org/0009-0008-8637-2708"]},"institutions":[{"id":"https://openalex.org/I4210109219","display_name":"Mercy Catholic Medical Center","ror":"https://ror.org/01k05jx47","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1314179348","https://openalex.org/I4210109219"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rachita Kour","raw_affiliation_strings":["Division of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19023, USA"],"raw_orcid":"https://orcid.org/0009-0008-8637-2708","affiliations":[{"raw_affiliation_string":"Division of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19023, USA","institution_ids":["https://openalex.org/I4210109219"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5136202853","display_name":"Anthony Costa","orcid":"https://orcid.org/0009-0001-6414-8157","observed_orcids":["https://orcid.org/0009-0001-6414-8157"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Anthony Costa","raw_affiliation_strings":["Department of Internal Medicine, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5149553805","display_name":"Shakeel Jamal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800698792","display_name":"Memorial Medical Center","ror":"https://ror.org/02hxrag63","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2800698792"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Shakeel Jamal","raw_affiliation_strings":["Division of Cardiology, Memorial Medical Center, Las Cruces, NM 88011, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Cardiology, Memorial Medical Center, Las Cruces, NM 88011, USA","institution_ids":["https://openalex.org/I2800698792"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5138965495","display_name":"Fayaz Hakim","orcid":"https://orcid.org/0009-0002-4369-464X","observed_orcids":["https://orcid.org/0009-0002-4369-464X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Fayaz Hakim","raw_affiliation_strings":["Electrophysiology Section, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Electrophysiology Section, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5054927126","display_name":"Hassaan Imtiaz","orcid":"https://orcid.org/0009-0007-2257-2359","observed_orcids":["https://orcid.org/0009-0007-2257-2359"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hassaan Imtiaz","raw_affiliation_strings":["Department of Hospital Medicine, McLaren Bay Region, Bay City, MI 48708, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Hospital Medicine, McLaren Bay Region, Bay City, MI 48708, USA","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5061136878","display_name":"Khalil Kanjwal","orcid":"https://orcid.org/0000-0002-2640-6610","observed_orcids":["https://orcid.org/0000-0002-2640-6610"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Khalil Kanjwal","raw_affiliation_strings":["Electrophysiology Section, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Electrophysiology Section, Henry Ford Genesys Hospital, Grand Blanc, MI 48439, USA","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5061136878"],"corresponding_institution_ids":[],"apc_list":{"value":2600,"currency":"CHF","value_usd":3137},"apc_paid":{"value":2600,"currency":"CHF","value_usd":3137},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"17","first_page":"6838","last_page":"6838"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":0.7695000171661377,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10065","display_name":"Atrial Fibrillation Management and Outcomes","score":0.7695000171661377,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11217","display_name":"Cardiac Arrhythmias and Treatments","score":0.22360000014305115,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10598","display_name":"Cardiac pacing and defibrillation studies","score":0.0019000000320374966,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/atrial-fibrillation","display_name":"atrial fibrillation","score":0.9739999771118164},{"id":"https://openalex.org/keywords/pulsed-field-ablation","display_name":"pulsed field ablation","score":0.9950000047683716},{"id":"https://openalex.org/keywords/radiation-exposure","display_name":"radiation exposure","score":0.7049999833106995},{"id":"https://openalex.org/keywords/3d-electroanatomical-mapping","display_name":"3D electroanatomical mapping","score":0.8410000205039978},{"id":"https://openalex.org/keywords/procedural-workflow","display_name":"procedural workflow","score":0.6010000109672546},{"id":"https://openalex.org/keywords/arrhythmia-recurrence","display_name":"arrhythmia recurrence","score":0.6660000085830688},{"id":"https://openalex.org/keywords/crossover-rate","display_name":"crossover rate","score":0.4180000126361847},{"id":"https://openalex.org/keywords/non-inferiority","display_name":"non-inferiority","score":0.7139999866485596}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9205999970436096},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.7348999977111816},{"id":"https://openalex.org/C2779161974","wikidata":"https://www.wikidata.org/wiki/Q815819","display_name":"Atrial fibrillation","level":2,"score":0.6814000010490417},{"id":"https://openalex.org/C2778902805","wikidata":"https://www.wikidata.org/wiki/Q322177","display_name":"Ablation","level":2,"score":0.652899980545044},{"id":"https://openalex.org/C2776131983","wikidata":"https://www.wikidata.org/wiki/Q436572","display_name":"Catheter ablation","level":3,"score":0.586899995803833},{"id":"https://openalex.org/C3020000205","wikidata":"https://www.wikidata.org/wiki/Q2412849","display_name":"Narrative review","level":2,"score":0.48559999465942383},{"id":"https://openalex.org/C19527891","wikidata":"https://www.wikidata.org/wiki/Q1120908","display_name":"Medical physics","level":1,"score":0.476500004529953},{"id":"https://openalex.org/C9652623","wikidata":"https://www.wikidata.org/wiki/Q190109","display_name":"Field (mathematics)","level":2,"score":0.397599995136261},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.3955000042915344},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3352999985218048},{"id":"https://openalex.org/C2781267111","wikidata":"https://www.wikidata.org/wiki/Q652297","display_name":"Catheter","level":2,"score":0.32989999651908875},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.31450000405311584},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.311599999666214},{"id":"https://openalex.org/C2910474132","wikidata":"https://www.wikidata.org/wiki/Q436572","display_name":"Cardiac Ablation","level":4,"score":0.31029999256134033},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.295199990272522},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.2939999997615814},{"id":"https://openalex.org/C2992234517","wikidata":"https://www.wikidata.org/wiki/Q322177","display_name":"Thermal ablation","level":3,"score":0.27250000834465027},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2721000015735626},{"id":"https://openalex.org/C2780226545","wikidata":"https://www.wikidata.org/wiki/Q6888030","display_name":"Modality (human\u2013computer interaction)","level":2,"score":0.2703000009059906},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2533000111579895},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.25200000405311584}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.3390/jcm15176838","doi":"https://doi.org/10.3390/jcm15176838","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15176838","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13565874","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13565874/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13565874/pdf/jcm-15-06838.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Clin Med","raw_type":"Text"},{"id":"pmid:42739841","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42739841","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of clinical medicine","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.3390/jcm15176838","doi":"https://doi.org/10.3390/jcm15176838","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15176838","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9537000060081482}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7207816205.pdf","grobid_xml":"https://content.openalex.org/works/W7207816205.grobid-xml"},"referenced_works_count":73,"referenced_works":["https://openalex.org/W1197576338","https://openalex.org/W2014782518","https://openalex.org/W2041904540","https://openalex.org/W2059492469","https://openalex.org/W2107690178","https://openalex.org/W2612100421","https://openalex.org/W2766219749","https://openalex.org/W2890938642","https://openalex.org/W2962816650","https://openalex.org/W2984471325","https://openalex.org/W3001856720","https://openalex.org/W3012865774","https://openalex.org/W3031550720","https://openalex.org/W3033718525","https://openalex.org/W3193961818","https://openalex.org/W3194066351","https://openalex.org/W4281799451","https://openalex.org/W4309317331","https://openalex.org/W4323652215","https://openalex.org/W4377088929","https://openalex.org/W4380990174","https://openalex.org/W4384925984","https://openalex.org/W4385145611","https://openalex.org/W4386203333","https://openalex.org/W4386923778","https://openalex.org/W4394576672","https://openalex.org/W4396994038","https://openalex.org/W4398140826","https://openalex.org/W4400422937","https://openalex.org/W4400642319","https://openalex.org/W4400665148","https://openalex.org/W4401834599","https://openalex.org/W4402460577","https://openalex.org/W4402787844","https://openalex.org/W4404238000","https://openalex.org/W4404647756","https://openalex.org/W4407105048","https://openalex.org/W4407217363","https://openalex.org/W4408362516","https://openalex.org/W4408972677","https://openalex.org/W4409000727","https://openalex.org/W4409118686","https://openalex.org/W4409281723","https://openalex.org/W4411338207","https://openalex.org/W4412885549","https://openalex.org/W4412979878","https://openalex.org/W4413115599","https://openalex.org/W4413913922","https://openalex.org/W4414084105","https://openalex.org/W4414247607","https://openalex.org/W4414338667","https://openalex.org/W4415152339","https://openalex.org/W4415208362","https://openalex.org/W4415461313","https://openalex.org/W4416079886","https://openalex.org/W4417036031","https://openalex.org/W4417289116","https://openalex.org/W7116782197","https://openalex.org/W7117241081","https://openalex.org/W7125254473","https://openalex.org/W7125404392","https://openalex.org/W7128179752","https://openalex.org/W7128230315","https://openalex.org/W7143491558","https://openalex.org/W7151864853","https://openalex.org/W7154037036","https://openalex.org/W7155193193","https://openalex.org/W7155486097","https://openalex.org/W7155648880","https://openalex.org/W7158567772","https://openalex.org/W7160490146","https://openalex.org/W7166177005","https://openalex.org/W7168031388"],"related_works":["https://openalex.org/W4407105048","https://openalex.org/W7165868580","https://openalex.org/W3027120569","https://openalex.org/W7158567772","https://openalex.org/W4409739102","https://openalex.org/W7165887418","https://openalex.org/W2208688308","https://openalex.org/W4401834599","https://openalex.org/W4414247607","https://openalex.org/W4409109808"],"abstract_inverted_index":{"Background:":[0],"Catheter":[1],"ablation":[2,38,114,311,331],"is":[3,40,81,142,155,179,361],"the":[4,29,93,121,129,356,362,392,444,463,470],"most":[5],"effective":[6],"rhythm-control":[7],"strategy":[8],"for":[9,21,136,169,207],"symptomatic":[10],"atrial":[11,208,373],"fibrillation":[12],"(AF).":[13],"A":[14],"fluoroless":[15,137,422],"approach":[16,110,445],"eliminates":[17],"ionizing":[18],"radiation":[19,124],"exposure":[20],"patients,":[22,371],"operators,":[23],"and":[24,27,71,88,108,126,132,151,174,204,221,230,247,266,271,280,297,319,336,340,406,417,443],"laboratory":[25],"staff":[26],"removes":[28],"ergonomic":[30],"burden":[31],"of":[32,85,123,278,284,322,369,391,412,458,466],"leaded":[33],"protective":[34],"garments.":[35],"Pulsed":[36],"field":[37,217],"(PFA)":[39],"a":[41,47,105,180,281,366,382,387,421,456],"predominantly":[42,432],"non-thermal":[43],"energy":[44],"modality":[45],"with":[46,64,115,196,275,329,381,414,440],"distinct":[48],"safety":[49],"profile,":[50],"now":[51],"addressed":[52],"in":[53,348,365,425],"dedicated":[54],"international":[55],"consensus":[56],"documents.":[57],"Several":[58],"PFA":[59,328,413],"catheters":[60],"are":[61,72,287],"natively":[62],"integrated":[63],"three-dimensional":[65],"electroanatomical":[66],"mapping":[67],"(3D":[68],"EAM)":[69],"platforms":[70],"therefore":[73],"well":[74],"suited":[75],"to":[76,83,103,111,119,127,158,187],"fluoroscopy-free":[77],"workflows.":[78],"This":[79,100,178],"review":[80,120],"confined":[82],"two":[84,117],"them\u2014Sphere-9":[86],"(Affera/Medtronic)":[87],"VARIPULSE":[89],"(Biosense":[90],"Webster)\u2014with":[91],"which":[92],"authors":[94],"have":[95],"direct":[96],"procedural":[97,153,234,276],"experience.":[98],"Objective:":[99],"study":[101,315],"seeks":[102],"describe":[104],"practical,":[106],"expert-":[107],"experience-based":[109],"zero-fluoroscopy":[112,270,439],"AF":[113,273,398],"these":[116],"catheters,":[118],"harms":[122],"exposure,":[125],"synthesize":[128],"currently":[130],"available":[131],"still":[133],"limited":[134],"evidence":[135,326,430],"PFA.":[138],"The":[139,428],"workflow":[140,423],"presented":[141],"explicitly":[143],"not":[144,300,462],"an":[145],"evidence-validated":[146],"or":[147,167,171,213,235,295],"broadly":[148],"generalizable":[149],"algorithm,":[150],"each":[152],"step":[154],"labeled":[156],"according":[157],"whether":[159],"it":[160],"rests":[161],"on":[162,355],"comparative":[163],"data,":[164],"device-specific":[165],"studies":[166],"instructions":[168],"use,":[170],"institutional":[172],"practice":[173,453],"expert":[175,452],"opinion.":[176],"Methods:":[177],"structured":[181],"narrative":[182],"review.":[183],"PubMed/MEDLINE":[184],"was":[185,376,399],"searched":[186],"30":[188,193],"June":[189,194],"2026":[190],"(final":[191],"search":[192],"2026),":[195],"no":[197,345,434],"lower":[198],"date":[199],"restriction,":[200],"using":[201],"controlled":[202],"vocabulary":[203],"free-text":[205],"terms":[206],"fibrillation,":[209],"catheter":[210],"ablation,":[211,218,274],"zero":[212],"minimal":[214],"fluoroscopy,":[215,467],"pulsed":[216],"Sphere-9,":[219],"Affera,":[220],"VARIPULSE.":[222],"English-language":[223],"randomized":[224,367,435],"trials,":[225],"cohorts,":[226],"registries,":[227],"systematic":[228],"reviews,":[229],"society":[231],"documents":[232],"reporting":[233],"clinical":[236],"outcomes":[237],"were":[238,242,251],"eligible;":[239],"reference":[240],"lists":[241],"hand-searched.":[243],"Conference":[244],"abstracts,":[245],"preprints,":[246],"non-peer-reviewed":[248],"manufacturer":[249],"reports":[250],"excluded":[252],"from":[253,397],"all":[254],"numerical":[255],"statements.":[256],"Results:":[257],"Four":[258],"meta-analyses":[259],"report":[260],"comparable":[261,333],"acute":[262],"success,":[263],"arrhythmia":[264],"recurrence,":[265],"complication":[267,338],"rates":[268,339],"between":[269,308],"fluoroscopy-guided":[272,441],"feasibility":[277],"95.1%":[279],"crossover":[282],"rate":[283],"1.26%.":[285],"These":[286],"pooled":[288],"observational":[289],"comparisons":[290],"without":[291],"pre-specified":[292],"non-inferiority":[293],"designs":[294],"margins,":[296],"they":[298],"should":[299,448],"be":[301,449],"read":[302],"as":[303,451],"establishing":[304],"formal":[305],"non-inferiority.":[306],"Differences":[307],"them":[309],"reflect":[310],"technology,":[312],"imaging":[313],"strategy,":[314],"period,":[316],"operator":[317],"experience,":[318],"heterogeneous":[320],"definitions":[321],"\u201czero":[323],"fluoroscopy\u201d.":[324],"Randomized":[325],"comparing":[327],"thermal":[330],"shows":[332],"12-month":[334,395],"efficacy":[335],"major":[337],"shorter":[341],"procedure":[342],"duration":[343],"but":[344],"consistent":[346],"reduction":[347],"fluoroscopy":[349,374],"time\u2014a":[350],"finding":[351],"that":[352],"bears":[353],"directly":[354],"present":[357],"topic.":[358],"Sheath":[359],"visualization":[360],"decisive":[363],"enabler:":[364],"trial":[368,436],"100":[370],"left":[372],"time":[375],"0":[377],"s":[378],"(IQR":[379],"0\u20130)":[380],"visualizable":[383],"steerable":[384],"sheath.":[385],"In":[386],"nonrandomized":[388],"subgroup":[389],"analysis":[390],"AdmIRE":[393],"trial,":[394],"freedom":[396],"similar":[400],"across":[401],"zero-":[402],"(72.1%),":[403],"low-":[404],"(75.4%)":[405],"conventional-fluoroscopy":[407],"(73.6%)":[408],"strategies.":[409],"Conclusions:":[410],"Integration":[411],"3D":[415],"EAM":[416],"intracardiac":[418],"echocardiography":[419],"makes":[420],"practical":[424],"experienced":[426],"hands.":[427],"supporting":[429],"remains":[431],"observational;":[433],"has":[437],"compared":[438],"PFA,":[442],"described":[446],"here":[447],"regarded":[450],"rather":[454],"than":[455],"standard":[457],"care.":[459],"Patient":[460],"safety,":[461],"absolute":[464],"avoidance":[465],"must":[468],"remain":[469],"governing":[471],"principle.":[472]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-04T00:00:00"}
