ADVENT

Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation

Patient / Population Intervention / Exposure Comparison Outcome

In 607 patients with paroxysmal AF, pulsed-field ablation was non-inferior to conventional thermal ablation for treatment success and safety.

607

Design

Randomised, non-inferiority RCT

Endpoint

Freedom from atrial arrhythmia + safety composite

Relevance

Result73.3 % vs 71.3 % efficacy; serious adverse events 2.1 % vs 1.5 %.

Reddy VY, et al. N Engl J Med. 2023;389(18):1660-1671. 10.1056/NEJMoa2307291

Discussion & critique

First randomised PFA-versus-thermal trial. Non-inferiority, not superiority — PFA's appeal is tissue selectivity and workflow rather than higher efficacy.