Key result
Linear PFA for CTI ablation matches RF safety and efficacy while improving procedural efficiency.
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Why the study?
To compare bipolar linear PFA and RF ablation for CTI, integrate preclinical lesion modeling with clinical dosing, and establish a standardized reliable coronary safety protocol.
Does bipolar linear pulsed field ablation provide similar safety and efficacy compared to standard radiofrequency ablation for cavotricuspid isthmus ablation in patients with typical atrial flutter?
Does bipolar linear pulsed field ablation provide similar safety and efficacy compared to standard radiofrequency ablation for cavotricuspid isthmus ablation in patients with typical atrial flutter?
Linear pulsed field ablation for cavotricuspid isthmus ablation in typical atrial flutter appears to offer similar safety and efficacy to standard radiofrequency ablation, but with greater procedural efficiency.
May support linear PFA for efficient CTI ablation; leaves open need for randomized confirmation before practice change.
This subanalysis of ADVANTAGE AF extends the primary results by allowing comparison of bipolar linear PFA and RF ablation for CTI, integrating preclinical lesion modeling with clinical dosing, and establishing a standardized reliable coronary safety protocol. Although not randomized comparisons, these findings suggest that CTI ablation with a linear PFA catheter is associated with safety and efficacy similar to RF ablation and greater efficiency. (A Prospective Single Arm Open Label Study of the FARAPULSE Pulsed Field Ablation System in Subjects With Persistent Atrial Fibrillation [ADVANTAGE AF; NCT05443594]).
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Gerstenfeld et al. (2026) studied this question. CTI ablation with linear PFA catheter shows safety and efficacy similar to RF ablation but with greater procedural efficiency.
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