false
Catalog
The Lead Episode 29: A Discussion of Pulsed Field ...
New England Journal of Medicine
New England Journal of Medicine
Back to course
Pdf Summary
A study conducted by the ADVENT Investigators compared the efficacy and safety of pulsed field ablation with conventional thermal ablation for the treatment of paroxysmal atrial fibrillation. Pulsed field ablation delivers high-voltage electrical fields in microseconds, which may limit damage to tissues outside the heart. The randomized, single-blind, noninferiority trial included 305 patients assigned to pulsed field ablation and 302 patients assigned to thermal ablation. <br /><br />After one year, the primary efficacy endpoint of freedom from initial procedural failure, documented atrial tachyarrhythmia after a 3-month blanking period, antiarrhythmic drug use, cardioversion, or repeat ablation was met in 73.3% of patients in the pulsed field ablation group and 71.3% of patients in the thermal ablation group. The difference between the two groups was 2.0 percentage points, with a 95% Bayesian credible interval of 5.2 to 9.2. The posterior probability of noninferiority was 0.999. <br /><br />Regarding safety, primary safety endpoint events occurred in 2.1% of patients in the pulsed field ablation group and 1.5% of patients in the thermal ablation group. The difference between the two groups was 0.6 percentage points, with a 95% Bayesian credible interval of 1.5 to 2.8. The posterior probability of noninferiority was 0.999. <br /><br />Based on these results, the study concluded that pulsed field ablation is noninferior to conventional thermal ablation for patients with paroxysmal atrial fibrillation in terms of freedom from adverse events and procedural failure after one year. The study was funded by Farapulse–Boston Scientific and is registered with ClinicalTrials.gov (NCT04612244).
Keywords
ADVENT Investigators
pulsed field ablation
conventional thermal ablation
paroxysmal atrial fibrillation
efficacy
safety
randomized trial
noninferiority
primary efficacy endpoint
primary safety endpoint
Heart Rhythm Society
1325 G Street NW, Suite 500
Washington, DC 20005
P: 202-464-3400 F: 202-464-3401
E: questions@heartrhythm365.org
© Heart Rhythm Society
Privacy Policy
|
Cookie Declaration
|
Linking Policy
|
Patient Education Disclaimer
|
State Nonprofit Disclosures
|
FAQ
×
Please select your language
1
English