Pulsed field ablation versus conventional thermal ablation for paroxysmal atrial fibrillation: 4-year outcomes in the ADVENT-LTO study.

Here we present results from the ADVENT-LTO study, which provides extended follow-up of the ADVENT trial, the first randomized trial comparing PFA with conventional thermal ablation.

在这里，我们展示了ADVENT-LTO研究的结果，该研究提供了ADVENT试验的延长随访数据，ADVENT试验是首个比较PFA与传统热消融的随机试验。

In ADVENT-LTO, 364 patients with paroxysmal AF (183 PFA, 181 thermal; 237 men, 127 women) participated and were followed for 1,332 ± 147 days.

在ADVENT-LTO研究中，共有364名阵发性房颤患者（其中183名为PFA，181名为热消融；男性237人，女性127人）参与研究，并被随访了1,332 ± 147天。

For the primary endpoint of 4-year treatment success, PFA demonstrated preserved effectiveness compared to thermal ablation (72.8% PFA, 64.3% thermal; P = 0.12).

在主要终点的4年治疗成功率方面，PFA显示出与热消融相比效果保持不变（PFA为72.8%，热消融为64.3%；P = 0.12）。

Moreover, there was a trend favoring PFA as compared to thermal ablation for the prespecified outcome of freedom from hospital-based arrhythmia intervention (85.6% PFA, 78.6% thermal; hazard ratio(HR) = 0.64, 95% confidence interval(CI): 0.38-1.05), including fewer repeat ablations (10.4% PFA, 17.7% thermal; P = 0.04) as well as a trend favoring PFA as compared to thermal ablation for the prespecified outcome of progression to persistent AF (2.6% PFA, 4.6% thermal; HR = 0.55, 95% CI: 0.16-1.88).

此外，与热消融相比，PFA对于预先设定的无医院心律失常干预的结果显示出一定的优势（PFA 85.6%，热消融 78.6%；风险比（HR）= 0.64，95% 置信区间（CI）：0.38-1.05），包括较少的重复消融（PFA 10.4%，热消融 17.7%；P = 0.04），以及与热消融相比，PFA在预先设定的进展为持续性房颤的结果上也显示出一定的优势（PFA 2.6%，热消融 4.6%；HR = 0.55，95% CI: 0.16-1.88）。

Taken together, these data demonstrate that the favorable outcomes of PFA are maintained over the course of 4 years.

综合这些数据，表明PFA的有利结果在4年的时间里得以维持。

Coupled with the safety advantages of PFA over thermal ablation, these long-term data support widespread adoption of PFA for the treatment of AF.

结合PFA相对于热消融的安全优势，这些长期数据支持广泛采用PFA治疗房颤。

ClinicalTrials.gov registration: NCT06526546 .

ClinicalTrials.gov注册号：NCT06526546。