Arrhythmias & electrophysiologyRandomised controlled trial
Pulsed Field Ablation as Initial Therapy for Persistent Atrial Fibrillation
- Randomised controlled trial
- international
- 2:1 randomisation
Authors' conclusion
Among patients with persistent atrial fibrillation, the risk of recurrence of atrial arrhythmia was significantly lower among those who received PFA as first-line treatment than among those who received antiarrhythmic-drug therapy.
Study context
- Population
- Patients with previously untreated persistent AFall with insertable cardiac monitor
- Comparison
- Pulsed field ablation (PFA) vs antiarrhythmic-drug therapy as initial treatment
- Primary endpoint
- Short- and long-term treatment success
- Follow-up
- 12 months
Primary result
Treatment success
Hazard ratio
0.46
95% CI 0.33–0.65
P < 0.001
Events by treatment group
PFA vs Antiarrhythmic-drug
HR 0.46 (95% CI 0.33–0.65); P < 0.001
As reported in the abstract
Safety
Serious adverse events · 12 months
- Device- and procedure-related serious adverse events (primary safety end point): Combined PFA 5.1%
- Device- and procedure-related serious adverse events (primary safety end point): combined PFA group: randomized and PFA-assigned, n = 257
Original publication
Pulsed Field Ablation as Initial Therapy for Persistent Atrial Fibrillation. N Engl J Med. Published 25 April 2026. doi:10.1056/nejmoa2600929
Summarised from the published abstract; every number is checked against it