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The recent, long-awaited ADVENT trial randomized patients undergoing ablation for paroxysmal atrial fibrillation (AF) to receive pulsed field ablation (PFA) or thermal ablation, which could be radiofrequency or cryoablation (NCT04612244; NEJM JW Cardiol Aug 28 2023 and N Engl J Med 2023; 389:1660). The trial, funded by the maker of the PFA system, showed no difference in 1-year outcomes with regard to either efficacy or safety. The efficacy endpoint was a composite that included time to first AF episode lasting 30 seconds or longer (post–3-month blanking period); however, a more meaningful outcome is total density of AF, which the trial investigators examined in the current substudy.
Transtelephonic electrocardiogram monitoring and 72-hour H…