Dual-Energy Ablation and Conduction System Pacing Show Positive Early Outcomes

Atrial fibrillation and other arrhythmias are common in both hospitalized and ambulatory patients, often complicating hemodynamic stability, stroke prevention, and perioperative care. Within this context, choices around ablation energy sources and physiologic pacing devices play a central role in determining safety, efficacy, and workflow. New late-breaking findings presented at a major electrophysiology meeting highlight progress on both fronts, with a dual-energy ablation catheter and novel conduction system pacing platforms demonstrating positive outcomes in early and mid-term evaluations.

At Heart Rhythm Society 2026 in Chicago, Abbott (Abbott Park, IL, USA) reported late-breaking results spanning pulsed field ablation and conduction system pacing. The programs included six-month outcomes from the FlexPulse IDE study evaluating the TactiFlex Duo Ablation Catheter, Sensor Enabled. Also included were new data from the Volt Pulsed Field Ablation (PFA) System for posterior wall ablation. In addition, investigators presented three-month results from the ASCEND CSP IDE trial of the investigational UltiSynq CSP implantable cardioverter-defibrillator lead, as well as a first-in-human evaluation of the investigational AVEIR CSP leadless pacemaker system. Both pacing data presentations were simultaneously published in Heart Rhythm.

The TactiFlex Duo catheter provides two energy modes to tailor therapy to complex disease or anatomy: radiofrequency energy, which uses heat to destroy tissue responsible for erratic heart signals, and pulsed field ablation, which uses high‑energy electrical pulses to destroy cells causing abnormal rhythms. The conduction system pacing technologies are designed to deliver left bundle branch pacing to more closely replicate the heart’s natural electrical activation. The UltiSynq lead is designed for implantation in the left bundle branch area or the right ventricle to deliver both pacing and defibrillation.

The FlexPulse IDE study was designed to secure U.S. Food and Drug Administration (FDA) approval for the TactiFlex Duo catheter, which received CE Mark in Europe earlier this year. The Volt PFA System secured U.S. FDA approval and CE Mark last year. The TactiFlex Duo catheter, AVEIR CSP leadless pacemaker system, and UltiSynq CSP lead remain approved for investigational use only in the United States.

In the 188‑patient FlexPulse IDE study, six‑month outcomes showed 87% of participants were free from documented arrhythmias. Safety was reported at 98.3% with no major safety events. Most participants (93.3%) were treated exclusively with pulsed field ablation, and 93.9% did not require an additional ablation after the first round of therapy.

In ASCEND, the investigational UltiSynq CSP lead met pre‑specified primary safety and effectiveness endpoints at three months. A first‑in‑human, 19‑patient study of the investigational AVEIR CSP leadless pacemaker reported a high implantation success rate, delivery of pacing that closely followed natural electrical pathways, reliable electrical performance through one month, and consistent device‑to‑device communication in a dual‑chamber setting. 

Six‑month data from the Volt CE Mark Extension Cohort confirmed freedom from atrial fibrillation recurrence when the posterior wall was treated in addition to standard therapy, with physicians reporting fewer therapy applications on average (4.1 per vein and 10.7 per posterior wall ablation) and no patient or procedure‑related complications.