Arrhythmias & electrophysiology
Pulsed Field Ablation vs Standard Radiofrequency Ablation for Typical Atrial Flutter: ADVANTAGE Atrial Fibrillation (AF) Trial Substudy
Authors' conclusion
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.
Study context
- Population
- Patients with persistent AF undergoing pulsed field ablation (PFA) with adjunctive cavotricuspid isthmus (CTI) ablation for typical atrial flutter
- Participants
- 141 vs 50
- Comparison
- Bipolar linear PFA vs irrigated radiofrequency ablation (RFA) for CTI ablation
- PFAn = 141
- RFAn = 50reference
Methodological detailsnon-randomised comparison, phase 1 vs phase 2 cohorts, with preclinical lesion study
- Non-randomised comparison
- Phase 1 vs phase 2 cohorts
- With preclinical lesion study
Primary result
As reported in the abstract
Acute CTI conduction block
P = 1.00
Further findings
CTI ablation time · PFA reported as shorter; values as printed
P = 0.001
Preclinical lesion depth
- Lesion depth increased at higher field strength and plateaued after 2 applications
Safety
Safety events
P = 0.96
Safety events
- No clinical coronary artery spasm with PFA after nitroglycerin pretreatment
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Pulsed Field Ablation vs Standard Radiofrequency Ablation for Typical Atrial Flutter: ADVANTAGE AF Trial Substudy. J Am Coll Cardiol. Published 6 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it