{
  "abstract": "Pulsed field ablation (PFA) and left atrial appendage closure (LAAC) are increasingly discussed as complementary strategies in atrial fibrillation (AF) care, addressing rhythm control and long-term thromboembolic risk. The rationale is attractive, but the current evidence base is uneven. Randomized evidence for LAAC around AF ablation is strongest for thermal-ablation-era workflows, particularly the OPTION trial, which showed lower non-procedure-related major or clinically relevant non-major bleeding with LAAC than with oral anticoagulation (OAC) and non-inferiority for death, stroke, or systemic embolism. Dedicated PFA-specific evidence remains limited to feasibility studies and early observational experience, and no trial has demonstrated that combined ablation-LAAC procedures are clinically superior when the ablation component is performed with PFA rather than radiofrequency or cryoballoon ablation. In parallel, OAC-withdrawal trials after apparently successful ablation, including OCEAN and ALONE-AF, have reported low thromboembolic event rates in selected lower-risk populations, whereas CLOSURE-AF cautions against simple extrapolation of LAAC benefit to older, frailer patients at high stroke and bleeding risk. This review therefore positions combined PFA-LAAC as a potential option for carefully selected patients rather than an established routine strategy. We summarize procedural workflow, patient selection, trial populations, device-platform considerations, reimbursement and organizational issues, and the main uncertainties that should guide future prospective studies.",
  "abstract_shown": true,
  "affiliations": [
    "Cardiology Department, St. Antonius Hospital Nieuwegein/Amsterdam University Medical Centre, Nieuwegein, the Netherlands.",
    "Cardiovascular Research Centre Aalst, AZORG Aalst, Aalst, Belgium.",
    "Department of Rhythmology, Asklepios Clinic Altona, Hamburg, Germany.",
    "Department of Rhythmology, University of Lübeck, Lubeck, Germany.",
    "Department of Cardiac Electrophysiology and Research, St. Bernard's Heart and Vascular Center, Arrhythmia Research Group, Jonesboro, AR, USA.",
    "Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.",
    "Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy.",
    "Department of Surgical, Biomedical and Dental Sciences, University of Milan, Milan, Italy.",
    "Customer Education, Boston Scientific EMEA, Milan, Italy.",
    "Health Economics and Market Access, Boston Scientific EMEA, Milan, Italy.",
    "Medical Affairs, Interventional Cardiology, Boston Scientific Middle East FZ LLC, PO Box 500745, Dubai Science Park, Dubai, United Arab Emirates.",
    "Department of Electrophysiology, Alfried Krupp Hospital, Essen, Germany.",
    "Department of Medicine, Witten/Herdecke University, Witten, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Lucas Boersma",
      "orcid": "0000-0003-4591-4220"
    },
    {
      "affs": [
        1
      ],
      "name": "Tom De Potter",
      "orcid": "0000-0003-1424-114X"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Christian-Hendrik Heeger",
      "orcid": "0000-0002-9014-8097"
    },
    {
      "affs": [
        4
      ],
      "name": "Devi Nair",
      "orcid": "0000-0001-8253-947X"
    },
    {
      "affs": [
        5
      ],
      "name": "Laurent Roten",
      "orcid": "0000-0002-0827-1329"
    },
    {
      "affs": [
        6
      ],
      "name": "Marco Schiavone",
      "orcid": "0000-0003-0720-3380"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Claudio Tondo",
      "orcid": "0000-0002-8500-8313"
    },
    {
      "affs": [
        8
      ],
      "name": "Pierpaolo Iozzia",
      "orcid": "0009-0003-0154-3082"
    },
    {
      "affs": [
        9
      ],
      "name": "Ilaria Giabbani"
    },
    {
      "affs": [
        10
      ],
      "name": "Mounia Haddad",
      "orcid": "0009-0006-4597-9007"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Kars Neven",
      "orcid": "0000-0002-2075-8113"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/92zhvtf7mm4tb.bib",
  "cited_by": 0,
  "doi": "10.1093/europace/euag202",
  "fulltext_url": "https://europepmc.org/articles/PMC13685791",
  "id": "92zhvtf7mm4tb",
  "issns": [
    "1099-5129",
    "1532-2092"
  ],
  "landing_url": "https://europepmc.org/article/MED/42905909",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Atrial Fibrillation Management and Outcomes"
    ]
  ],
  "openalex": "W7223151279",
  "pdf_url": "https://europepmc.org/articles/PMC13685791?pdf=render",
  "pmcid": "PMC13685791",
  "pmid": "42905909",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/92zhvtf7mm4tb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42905909",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42905909"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Atrial Fibrillation Management and Outcomes",
      "subfield": "cardiovascular"
    }
  ],
  "title": "The perspective of combining pulsed field ablation and left atrial appendage closure.",
  "title_text": "The perspective of combining pulsed field ablation and left atrial appendage closure.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/92zhvtf7mm4tb",
  "venue": "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",
  "versions": []
}