Evidence map›Paper›PMID 41652117›Full record

Trial reportNature medicine2026

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

Vivek Y Reddy, Edward P Gerstenfeld, Stavros E Mountantonakis, Chinmay Patel, Kenneth A Ellenbogen, John D Harding, Douglas N Gibson, Andrea Natale, Jonathan W Waks, Hugh Calkins and 11 more

Registry-linked trialAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06526546 (ADVENT Trial Long Term Outcomes Evaluating Atrial Fibrillation Progression), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06526546 completednot on this map

ADVENT Trial Long Term Outcomes Evaluating Atrial Fibrillation Progression (ADVENT LTO Study)

TypeobservationalSponsorBoston Scientific CorporationRan2024 to 2025Enrolled364ConditionsParoxysmal Atrial Fibrillation
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Procedural Management of Atrial Fibrillation in Older Patients.Reviews in cardiovascular medicine · 2026
    Review
  5. Review
  6. Pulsed field energy: a superior approach for ablation of paroxysmal atrial fibrillation? Evidence from randomized clinical trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Vivek Y ReddyHelmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY, USA. vivek.reddy@mountsinai.org.ORCID http://orcid.org/0000-0002-5638-4993
Edward P GerstenfeldUniversity of California, San Francisco, San Francisco, CA, USA.
Stavros E MountantonakisLenox Hill Hospital, Northwell Cardiovascular Institute, New York, NY, USA.
Chinmay PatelUniversity of Pittsburgh Medical Center Pinnacle, Harrisburg, PA, USA.
Kenneth A EllenbogenVirginia Commonwealth University, Richmond, VA, USA.
John D HardingDoylestown Hospital, Doylestown, PA, USA.
Douglas N GibsonScripps Clinic and Prebys Cardiovascular Institute, San Diego, CA, USA.
Andrea NataleTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
Jonathan W WaksBeth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-5560-5638
Hugh CalkinsJohns Hopkins Hospital, Baltimore, MD, USA.
Sanjaya K GuptaSaint Luke's Mid-America Heart Institute, Kansas City, MO, USA.
Christopher E WoodsSutter California Pacific Medical Center, San Francisco, CA, USA.
William WhangHelmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY, USA.
Marcos DaccarettSt. Luke's Medical Center, Boise, ID, USA.
Frank A CuocoCharleston Heart Specialists, Trident Medical Center, Charleston, SC, USA.
David B DelurgioEmory University Hospital, Atlanta, GA, USA.
Elizabeth RichardsBoston Scientific Corporation, St. Paul, MN, USA.
Matthew D MartensBoston Scientific Corporation, St. Paul, MN, USA.ORCID http://orcid.org/0000-0001-9251-6693
Brad SuttonBoston Scientific Corporation, St. Paul, MN, USA.
Moussa MansourHeart and Vascular Institute, Mass General Brigham, Boston, MA, USA.
ADVENT-LTO Study Investigators

Funding

Boston Scientific Corporation (Boston Scientific) n/a
6 · The paper itself

Abstract

Pulsed field ablation (PFA) has proven to be a safe and effective non-thermal ablation modality for the treatment of atrial fibrillation (AF), but little outcome data beyond 1 year have been reported. 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. 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. 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). 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). Taken together, these data demonstrate that the favorable outcomes of PFA are maintained over the course of 4 years. Coupled with the safety advantages of PFA over thermal ablation, these long-term data support widespread adoption of PFA for the treatment of AF. ClinicalTrials.gov registration: NCT06526546 .

Indexed as

Atrial FibrillationCatheter AblationAgedFemaleHumansMaleMiddle AgedTreatment Outcome

Identifiers

PMID41652117
PMCPMC13099369

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.