Arrhythmias & electrophysiologySecondary analysis

Pulsed Field Ablation vs Standard Radiofrequency Ablation for Typical Atrial Flutter

J Am Coll CardiolPublished

  • Secondary analysis of the ADVANTAGE atrial fibrillation (AF) study
  • non-randomised comparison
  • phase 1 vs phase 2 cohorts
  • with preclinical lesion study

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

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. J Am Coll Cardiol. Published 6 February 2026. doi:10.1016/j.jacc.2025.12.081

Summarised from the published abstract; every number is checked against it