Study of Pulsed Field Ablation Compared to Radiofrequency Ablation for Treating Atrial Fibrillation

What this Trial Is About

Atrial fibrillation AF is a common heart rhythm disorder affecting millions worldwide and increasing risks of stroke, blood clots, and heart failure, which can greatly reduce quality of life. Catheter ablation is a key treatment to restore normal rhythm and has shown better results than medication. This study evaluates a new technique called pulsed electric field ablation PFA, which targets heart cells while sparing nearby tissues, aiming to improve treatment success and protect heart function in a large randomized trial. Participants will receive either pulsed field ablation using a specialized catheter or traditional radiofrequency ablation. For paroxysmal AF, PFA involves isolating pulmonary veins and ablating the left atrial wall, while persistent AF treatment adds mitral valve isthmus ablation. The radiofrequency group will receive pulmonary vein isolation and additional ablation based on their condition. Both groups may receive medication or electrical cardioversion if normal rhythm is not restored during the procedure. During the study, participants will be monitored for 12 months after ablation to track AF recurrence, changes in AF burden, heart pumping function, and quality of life using surveys. Safety will also be assessed, including overall survival. The study involves regular follow-up visits and evaluations to compare the outcomes and safety of the two ablation methods over one year.

Pulsed Field Ablation Outcomes With Efficacy and Randomization in Atrial Fibrillation (POWER-AF)