Launched in March 2021 for a period of five years, the BEAT-AF project aimed to evaluate the superiority and efficacy of pulsed field ablation in pulmonary vein isolation, compared with radiofrequency ablation, the standard treatment for atrial fibrillation (AF). It will come to an end in February 2026.
As part of the BEAT-AF project, the BEAT PAROX-AF multicenter, randomized European clinical trial compared optimized radiofrequency ablation (RFA) and pulsed-field ablation (PFA) in the treatment of symptomatic, drug-resistant paroxysmal atrial fibrillation (AF) in 300 patients undergoing a first procedure.
Catheter ablation
Both pulsed field ablation and radiofrequency ablation procedures are performed using a catheter. Inserted into the femoral vein, the catheter is guided by the cardiologist into the left atrium, where it will remove the areas of heart tissue around the pulmonary veins that trigger or maintain AF. Isolating these veins through ablation reduces or eliminates episodes of AF, significantly improving patients’ quality of life.
Pulsed field ablation: comparable efficacy, enhanced safety
A 12-month post-operative follow-up of these patients showed no recurrence of atrial arrhythmia in approximately 77% of patients in both groups. The BEAT PAROX-AF study therefore does not demonstrate superiority but rather similar efficacy between the two techniques.
In terms of safety, pulsed-field ablation results in fewer serious complications related to the procedure. Pulmonary vein shrinkage, in particular, occurred only in the radiofrequency-treated group. No deaths, strokes, atrioesophageal fistulas, or permanent phrenic nerve damage were reported in either group.
Finally, PFA offers the advantage of a significantly shorter procedure time, with less time spent inside the left atrium. In the future, this time saving could confirm the rise in popularity of pulsed field energy and improve access to ablation treatment for patients.
At the end of the BEAT PAROX-AF study, the data show that pulsed-field ablation offers advantages in terms of safety and are reassuring for patients, who can expect very good results in the treatment of AF, regardless of the technique used.
The BEAT-AF consortium brings together eight partners across Europe (France, Germany, Belgium, Austria, Czech Republic) and one partner in the United States. The project is coordinated by the University of Bordeaux.