Arrhythmias & electrophysiologyCohort study
Pulsed Field Ablation of Persistent Atrial Fibrillation With Continuous Electrocardiographic Monitoring Follow-Up: ADVANTAGE AF Phase 2
- Prospective single-arm open-label study
- multicentre
Authors' conclusion
In Phase 2 of ADVANTAGE AF, the first multicenter PerAF study of PFA with continuous rhythm monitoring: (1) cavotricuspid isthmus ablation with nitroglycerin prophylaxis was safe and effective, (2) PVI plus posterior wall ablation was safe and effective, and (3) an AA burden <0.1% and AA episode <1 hour duration were end points associated with the lowest health care use.
Study context
- Population
- Patients with persistent AF141 also CTI ablation
- Participants
- 255 patients
- Outcome
- Freedom from atrial arrhythmia, emulating traditional intermittent monitoring (insertable cardiac monitors)
- Follow-up
- 1 year
Main finding
As reported in the abstract
Freedom from atrial arrhythmia (AA), mimicking traditional monitoring
73.4%
Observational data: associations, not effects.
Further findings
Freedom from recurrent atrial flutter
- Freedom from recurrent atrial flutter
- 97.2%
Full insertable cardiac monitor data
- Freedom from AA of ≥30 seconds
- 52.0%
- No episode exceeding 24 hours
- 94.0%
One-year procedural effectiveness by burden and duration thresholds
- Effectiveness, threshold ≤0.1% burden
- 71.6%
- Effectiveness, threshold <1 hour duration
- 70.0%
- AA burden >0.1% and longest episode >1 hour predictive of increased health care use
CTI ablation acute success (subpopulation n=141)
- Bidirectional block without complications
- 98.6%
Safety
| Outcome | Values |
|---|---|
| Adverse events · met prespecified end-point criteria | PFA 2.4% |
Adverse events
- CTI ablation without complications (ST-segment changes, VF)
Original publication
Summarised from the published abstract; every number is checked against it