AF Symposium 25 - The MANIFEST-REDO sub-study suggests repeat ablation procedures due to clinical recurrence of atrial fibrillation (AF) can be performed safely and with an acceptable success rate.

Prof Daniel Scherr (Medical University, Graz, AT) joins us onsite at AF Symposium 25 to discuss the insights from MANIFEST-REDO, investigating repeated ablation following pulmonary vein isolation (PVI) with a pentaspline catheter (Farawave; Boston Scientific Inc). Patients with AF, persistent AF, or atrial tachycardia (AT) across 22 European centres were enrolled from the MANIFEST cohort, a trial assessing the safety and efficacy of pulsed field ablation (PFA) of AF. The primary effectiveness endpoint was freedom from documented AF or AT.

Findings showed that PFA with the pentaspline catheter achieved the primary effectiveness endpoint in over half of the patients; however, PV reconnections were not uncommon. MANIFEST-REDO also revealed that if additional imaging was used in the first procedure, as opposed to fluoroscopy alone, PVI durability was increased significantly.

Interview Questions:
1. Could you remind us of the reasoning behind MANIFEST-REDO?
2. Could you tell us about the study design and patient population?
3. What were the key findings?
4. How do the MANIFEST-REDO findings shed new light on the findings from MANIFEST-PF?
5. How should these findings impact clinical practice?
6. What further research is needed?

Recorded on-site at AF Symposium in Boston, 2025.

Editors: Yazmin Sadik, Jordan Rance
Videographers: Oliver Miles, David Ben-Harosh
Interviewer: David Ramsey
Support: This is an independent interview produced by Arrhythmia Academy.