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March 6, 2023CirculationOpen Access

Pulsed Field Ablation for the Treatment of Atrial Fibrillation: PULSED AF Pivotal Trial

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Why the study?

Pulsed field ablation uses nonthermal irreversible electroporation and may have effectiveness comparable to traditional catheter ablation while preventing thermally mediated complications.

Does pulsed field ablation improve freedom from arrhythmia recurrence and procedural failure in patients with symptomatic atrial fibrillation refractory to antiarrhythmic drugs?

Population

Patients with paroxysmal (n=150) or persistent (n=150) drug-refractory symptomatic AF

Comparison

Pulsed field ablation (nonrandomized, paired single-arm cohorts)

Design

Prospective, global, multicenter, nonrandomized, paired single-arm study

Follow-up

1 year

Authors

AVAtul VermaDHDavid E. HainesLBLucas V.A. Boersma

Discussion

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Overview

PFA shows acceptable 1-year outcomes in paroxysmal AF; leaves open confirmation versus thermal ablation in randomized trials.

Structured PICO

Does pulsed field ablation improve freedom from arrhythmia recurrence and procedural failure in patients with symptomatic atrial fibrillation refractory to antiarrhythmic drugs?

P
Population
300 patients with paroxysmal (n=150) or persistent (n=150) symptomatic atrial fibrillation refractory to class I or III antiarrhythmic drugs, global.
I
Intervention
Pulsed field ablation
O
Outcome
Freedom from a composite of acute procedural failure, arrhythmia recurrence, or antiarrhythmic escalation through 12 months, excluding a 3-month blanking periodcomposite

Pulsed field ablation demonstrates a low rate of safety events and provides effectiveness consistent with established ablation technologies for treating refractory symptomatic atrial fibrillation.

Cite This Study

Verma et al. (2023) studied this question.

synapsesocial.com/papers/6a7cb40ccc6f1443deba6368https://doi.org/10.1161/circulationaha.123.063988
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