Arrhythmias & electrophysiology

Pulsed Field Ablation Using a Novel Biphasic Catheter vs Thermal Ablation for Paroxysmal Atrial Fibrillation: InsightPFA Trial

J Am Coll CardiolPublished Randomised controlled trial

Primary resultResult — go to the resultAdjusted rate difference 2.0% 95% CI −8.7% to 12.8%

Authors' conclusion

The nsPFA exhibited noninferior efficacy and comparable safety to AI-guided RFA while obviating the need for general anesthesia.

Study context

Population
Patients with paroxysmal AF, 13 centres in China13 centres in China
Participants
287 patients
Comparison
Nanosecond pulsed field ablation (nsPFA) vs ablation index (AI)-guided radiofrequency ablation (RFA) for pulmonary vein isolation
Primary endpoint
Freedom from documented atrial tachyarrhythmia recurrence without class I or III antiarrhythmic drugs
Follow-up
12 months
Methodological detailsprospective, multicentre, non-inferiority
  • Prospective
  • Multicentre
  • Non-inferiority

Primary result

As reported in the abstract

Adjusted rate difference

2.0%

95% CI −8.7% to 12.8%

P = 0.0019 for noninferiority

Events by treatment group

nsPFAvs AI-guided RFA
adjusted rate difference 2.0% (95% CI −8.7% to 12.8%); P = 0.0019 for noninferiority

Secondary outcomes

OutcomensPFAAI-guided RFAHR (95% CI)P value
12-month Kaplan-Meier treatment success66.7%67.4%0.99 (0.66–1.48)P = 0.0020 for noninferiority

Acute procedural success

Procedural measures

nsPFA: significantly shorter total procedure time, left atrial dwell time and ablation time; longer fluoroscopy times and higher radiation exposure doses

Safety

Procedure-related adverse events

No significant difference between the 2 groups

Original publication

Pulsed Field Ablation Using a Novel Biphasic Catheter vs Thermal Ablation for Paroxysmal Atrial Fibrillation: InsightPFA Trial. J Am Coll Cardiol. Published 9 December 2025. doi:10.1016/j.jacc.2025.09.1593

Composed by AI from the published abstract and checked against it. How Briefs are made →

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