When low is not low enough: zero-fluoroscopy atrial fibrillation ablation using the VARIPULSE™ pulsed field system—a prospective single-center study

This study demonstrates the feasibility, safety, and time-efficiency of a fully standardized fluoroscopy-free workflow, including posterior wall and CTI ablation. The use of TEE instead of ICE enhances cost-efficiency, potentially facilitating broader adoption of the protocol. However, the single-center nature of the study and the lack of a comparative fluoroscopy group represent important limitations.