Second phase of ADVANTAGE AF study of FARAPULSE Pulsed Field Ablation System meets primary safety and efficacy endpoints – Boston Scientific

Boston Scientific announced positive 12-month primary endpoint results from the second phase of the ADVANTAGE AF clinical trial evaluating the use of the Farapulse Pulsed Field Ablation (PFA) System and adjunctive use of the FARAPOINT PFA Catheter in patients with persistent atrial fibrillation (AF).  Key findings from the study were presented at the second annual PFA Live Case Summit in San Diego and simultaneously published in Circulation.

Persistent AF, which accounts for approximately 25% of all AF cases, is an abnormal, rapid heartbeat that lasts for at least seven days in a row and can lead to complications such as blood clots, stroke and heart failure. The second phase of the ADVANTAGE AF trial studied the FARAWAVE PFA Catheter for both pulmonary vein isolation (PVI) and posterior wall ablation (PWA) and the FARAPOINT PFA Catheter for cavotricuspid isthmus (CTI) ablation to treat typical atrial flutter (AFL), a type of heart rhythm disorder. All patients in the trial were continuously monitored after their procedure with the LUX-Dx Insertable Cardiac Monitor (ICM) System, which is designed to detect recurrence of cardiac arrhythmias and assess AF burden. Findings from the trial met all pre-specified safety and effectiveness endpoints and demonstrated:

• 73.4% freedom from AF, AFL and atrial tachycardia (AT), which exceeded the performance goal of 40% or higher.
• A safety event rate of 2.4% and no reports of pulmonary vein stenosis, atrio-esophageal fistula or phrenic nerve palsy which met the performance goal of 12% or lower.
• 81.0% freedom from symptomatic documented AF recurrence, which is defined as arrhythmia, clinical intervention or use of escalated or new Class I/III anti-arrhythmic drugs.
• 71.6% of patients had virtually no atrial arrhythmia (AA) burden, in which data shows lower AA burden can be associated with fewer clinical interventions and improvements in quality of life and 52% of patients had no residual AA events after the blanking period.
• 96.4% of patients treated with the FARAPOINT PFA Catheter had no recurrence of AFL.

This prospective, single arm  trial included 255 patients enrolled at 29 U.S. sites who were treated with the FARAWAVE PFA Catheter, and of those, 141 patients also received CTI ablation with the FARAPOINT PFA Catheter for AFL. The FARAPOINT PFA Catheter is a navigation-enabled point catheter that uses a smaller ablation footprint to create focal and linear-shaped lesions and integrates with the Boston Scientific OPAL HDx Mapping System to provide visualization of catheter placement during procedures. The ADVANTAGE AF IDE (Phase II) Clinical Trial is the first trial to assess PFA effectiveness using the focal FARAPOINT Pulsed Field Ablation Catheter and LUX-DX  Insertable Cardiac Monitor (ICM) System.

“These positive study results are an important step forward in the continued innovation of the proven Farapulse PFA System and our broader portfolio of products that treat AF,” said Dr.  Brad Sutton, chief medical officer, AF Solutions, Boston Scientific. “The performance of the devices in this trial – the FARAPOINT and FARAWAVE PFA Catheters as well as the LUX-Dx ICM System – is an encouraging sign as we work towards expanding our portfolio to provide physicians with an even more robust toolset to treat the growing number of patients with AF.”

“Continuous rhythm monitoring in phase two of the ADVANTAGE AF study allowed for a detailed picture of patients’ cardiac rhythm after ablation, including asymptomatic AF recurrence, which is not often captured in U.S. Food and Drug Administration clinical trial monitoring but is important for the ability to provide more individualized care to patients,” said Dr. Vivek Reddy, director, Cardiac Arrhythmia Services, Mount Sinai Health System and Leona M. and Harry B. Helmsley Charitable Trust professor of medicine, Cardiac Electrophysiology, Icahn School of Medicine and study principal investigator. “The data collected in this trial continues to support the FARAPULSE PFA System as a safe and effective therapy, now with evidence highlighting positive results for its use in treating patients who suffer from persistent AF

See citation- Reddy VY, Gerstenfeld EP, Schmidt B et al. Pulsed Field Ablation of Persistent Atrial Fibrillation With Continuous ECG Monitoring Follow-Up: ADVANTAGE AF-Phase 2. Circulation. 2025 Apr 24. doi: 10.1161/CIRCULATIONAHA.125.074485. Online ahead of print. PMID: 4027332