Arrhythmias & electrophysiology
Pulsed Field vs Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation: Recurrent Atrial Arrhythmia Burden
Primary result · Residual AA burden <0.1%Result — go to the resultOdds ratio 1.5 95% CI 1.0–2.3Authors' conclusion
Compared with thermal ablation, PFA more often resulted in an AA burden less than the clinically significant threshold of 0.1% burden.
Study context
- Population
- Symptomatic drug-refractory patients with paroxysmal AFrandomized
- Participants
- 593 patients
- Comparison
- Pulsed field ablation (PFA) vs thermal ablation
- PFAn = 299
- Thermaln = 294reference
- Primary endpoint
- Residual postablation AA burden <0.1%
Primary result
Residual AA burden <0.1%
Odds ratio
1.5
95% CI 1.0–2.3
P = 0.04
PFA vs Thermal
OR 1.5 (95% CI 1.0–2.3); P = 0.04
As reported in the abstract
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Residual AA burden, prior failed class I/III antiarrhythmic drugs (subgroup)Less residual AA burden after PFA | 2.5 (1.4–4.3) | P = 0.002 | |
| 0.20.5125Odds ratio (log scale) |
Atrial arrhythmias (AA) burden >0.1% and outcomes (aggregate PFA/thermal data)
- AA burden >0.1% associated with significantly reduced quality of life and more redo ablation, cardioversion and hospitalization
AA burden, only class II/IV antiarrhythmic drugs pre-ablation (subgroup)
- No difference in AA burden between ablation groups
Original publication
Pulsed Field vs Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation: Recurrent Atrial Arrhythmia Burden. J Am Coll Cardiol. Published 18 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it