Late-breaking data presented at AF Symposium 2025 highlight key Boston Scientific therapies for management of patients with atrial fibrillation

Rhea-AI Summary

Boston Scientific (BSX) announced positive clinical data for two key atrial fibrillation therapies at AF Symposium 2025. The ADVANTAGE AF trial for the FARAPULSE™ PFA System met its primary endpoints, showing a 2.3% safety event rate and 63.5% effectiveness rate in treating persistent AF patients, with an 85.3% symptomatic AF recurrence-free rate.

A sub-analysis of the OPTION trial demonstrated that the WATCHMAN FLX™ device significantly reduced bleeding outcomes compared to oral anticoagulants. Concomitant procedures showed a 44% reduction (8.0% vs. 13.3%) while sequential procedures demonstrated a 62% reduction (8.8% vs. 21.5%) in non-procedural bleeding at 36 months. Both approaches maintained similar efficacy outcomes and stroke protection compared to oral anticoagulants.

Positive

• FARAPULSE PFA System achieved primary safety endpoint with low 2.3% event rate
• 85.3% symptomatic AF recurrence-free rate in ADVANTAGE AF trial
• WATCHMAN FLX device showed 44% reduction in bleeding outcomes for concomitant procedures
• 62% reduction in bleeding outcomes for sequential procedures with WATCHMAN FLX
• Similar efficacy outcomes and stroke protection compared to oral anticoagulants

Negative

• Primary effectiveness endpoint of 63.5% indicates treatment failure in 36.5% of cases

Insights

Medical Research Analyst

The late-breaking clinical trial results for Boston Scientific's FARAPULSE PFA System and WATCHMAN FLX Device represent significant clinical milestones with substantial market implications. The ADVANTAGE AF trial's success in treating persistent AF patients - representing 25% of all AF cases - opens a major new market opportunity beyond the current paroxysmal AF indication.

Key performance metrics are impressive: 85.3% symptomatic AF recurrence-free rate, improving to 91.8% with experienced operators, coupled with a low 2.3% adverse event rate. These outcomes position BSX competitively in the growing PFA market segment.

The OPTION trial sub-analysis reinforces WATCHMAN FLX's clinical value, demonstrating a 44% reduction in bleeding events for concomitant procedures and 62% for sequential procedures versus oral anticoagulants, while maintaining comparable stroke protection. This data strengthens the device's market position against both pharmaceutical alternatives and competing devices.

Market Research Analyst

This data release strengthens Boston Scientific's competitive position in two key growth markets: cardiac ablation and left atrial appendage closure. The expanded indication potential for FARAPULSE in persistent AF patients could unlock a substantial revenue opportunity, considering these patients often require more complex and higher-priced procedures.

The WATCHMAN FLX data is particularly valuable as it supports both immediate post-ablation and delayed device implantation strategies, giving clinicians flexibility in treatment planning. This versatility, combined with superior bleeding risk reduction, should support continued market share gains in the LAAC segment, where BSX already holds a dominant position.

The timing of these presentations at AF Symposium 2025 is strategically important, as it allows BSX to showcase its innovation leadership to key opinion leaders and practitioners, potentially accelerating adoption rates for both technologies.

First phase of ADVANTAGE AF clinical trial achieves safety and effectiveness endpoints for treatment of drug-resistant, symptomatic, persistent atrial fibrillation with the FARAPULSE™ Pulsed Field Ablation System

Sub-analysis from OPTION clinical trial highlights consistent safety and efficacy outcomes with the WATCHMAN FLX™ Left Atrial Appendage Closure Device post cardiac ablation in both concomitant and sequential procedures

MARLBOROUGH, Mass., Jan. 16, 2025 /PRNewswire/ -- Boston Scientific Corporation (NYSE: BSX) today announced data supporting the use of the FARAPULSE™ Pulsed Field Ablation (PFA) System* and the WATCHMAN FLX™ Left Atrial Appendage Closure (LAAC) Device, respectively, during a late-breaking science session at AF Symposium 2025.

ADVANTAGE AF clinical study

Currently, the FARAPULSE PFA System is approved for pulmonary vein isolation (PVI) in patients who have paroxysmal AF, an irregular heartbeat that occurs occasionally and typically spontaneously resolves back to normal rhythm. The ADVANTAGE AF study examined use of the FARAPULSE PFA System for both PVI and posterior wall ablation (PWA) in patients who have persistent AF, where individuals experience an irregular or rapid heartbeat that lasts longer than seven days and which represent 25% of all AF cases.¹ The prospective, single arm trial included 260 patients enrolled at 43 global sites who were drug intolerant to at least one Class I/III anti-arrhythmic drug (AAD).

Key findings from the study through 12 months included:

• The primary safety endpoint – defined as serious adverse events related to either the use of an ablation catheter or the ablation procedure within seven days of the primary procedure and pulmonary vein stenosis or atrio-esophageal fistula out to 12 months – was met with a 2.3% event rate.
• The primary effectiveness endpoint – defined as freedom from AF, atrial flutter, atrial tachycardia, re-ablation, cardioversion and use of a new or escalated dose of Class I/III AAD or amiodarone – was met at 63.5%.
• The symptomatic AF recurrence-free rate was 85.3% and observationally, among physicians that performed three or more procedures, the symptomatic recurrence-free rate increased to 91.8%.
• There were no reported incidences of stroke, pulmonary vein stenosis, atrio-esophageal fistula or major access complications.

"In addition to the positive safety and efficacy outcomes achieved in the ADVANTAGE AF study, a significant number of patients were able to discontinue AADs as well as see greater improvements in quality of daily life," said Vivek Reddy, M.D.**, director of electrophysiology, Mount Sinai Fuster Heart Hospital, New York and study principal investigator. "As the population of patients living with AF continues to grow, data from trials such as ADVANTAGE AF further support the paradigm shift to PFA as a treatment for patients who are living with persistent and other complex forms of AF."

OPTION trial sub-analysis

The late-breaking session also included a prespecified sub-analysis from the OPTION clinical trial that built upon the positive primary endpoint results presented at the American Heart Association 2024 meeting and published in The New England Journal of Medicine.² In line with the overall 36-month outcomes from this first head-to-head study of the WATCHMAN FLX device and direct oral anticoagulants (95% DOAC, 5% warfarin), the sub-analysis of 1,600 patients with atrial fibrillation who underwent a device implantation either concomitantly or sequentially (90-180 days post ablation) demonstrated:

• Consistent with the previously presented primary safety and efficacy endpoint data presented in November 2024, concomitant LAAC with the WATCHMAN FLX device following an ablation demonstrated a statistically significant 44% reduction in non-procedural bleeding outcomes compared to OAC at 36 months (8.0% vs. 13.3%; p=0.02) and similar efficacy outcomes (7.0% vs. 6.7% p=0.91), with the primary efficacy endpoint defined as all-cause death, stroke or systemic embolism.
• Also consistent with the previously presented primary safety and efficacy endpoint data, sequential LAAC with the WATCHMAN FLX device following an ablation demonstrated a statistically significant 62% reduction in non-procedural bleeding outcomes compared to OAC at 36 months (8.8% vs. 21.5%; p<0.0001) and similar efficacy outcomes (4.2% vs. 5.3%; p=0.45).
• Similar stroke protection with the WATCHMAN FLX device compared to OAC irrespective of concomitant (2.3% vs. 2.5% rates of all stroke) or sequential (1.1% vs 1.6%) implantation.

"These late-breaking studies provide valuable clinical evidence supporting our ablation and stroke prevention technologies that are designed to improve long-term outcomes for patients with atrial fibrillation," said Dr. Brad Sutton, M.D., chief medical officer, Atrial Fibrillation Solutions, Boston Scientific. "The positive findings support our focus on expanding the number of patients who can benefit from these life-changing therapies, which we will continue to advance through future clinical trials and product development."

More information on the ADVANTAGE AF study is available here and on the OPTION trial here.***

About Boston Scientific
Boston Scientific transforms lives through innovative medical technologies that improve the health of patients around the world. As a global medical technology leader for more than 45 years, we advance science for life by providing a broad range of high-performance solutions that address unmet patient needs and reduce the cost of health care. Our portfolio of devices and therapies helps physicians diagnose and treat complex cardiovascular, respiratory, digestive, oncological, neurological and urological diseases and conditions. Learn more at www.bostonscientific.com and connect on LinkedIn and X, formerly Twitter.

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CONTACTS:
Becca Johnson
Media Relations
+1 (952) 994-8526
Rebecca.Johnson@bsci.com

Jon Monson
Investor Relations
+1 (508) 683-5450
BSXInvestorRelations@bsci.com

*CAUTION: Investigational Device. Limited by Federal (or US) law to investigational use only. Ablation beyond pulmonary vein isolation is outside the use of labeled indication of the FARAWAVE PFA Catheter with the FARAPULSE PFA System.

**Dr. Vivek Reddy is a paid consultant of Boston Scientific Corporation. He has not been compensated in connection with this press release.

*** The FARAPULSE PFA System was not commercially available at the time of the OPTION trial initiation and was not included in the trial design.

¹Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S. Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol. 2014;6:213-220. doi: 10.2147/CLEP.S47385
² Wazni OM, Saliba WI, Nair DG, et al. Left atrial appendage closure after ablation for atrial fibrillation. N Engl J Med. 2024 Nov 16. doi:10.1056/NEJMoa2408308

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SOURCE Boston Scientific Corporation

FAQ

What were the key results of BSX's ADVANTAGE AF trial for the FARAPULSE PFA System?

The trial met its primary endpoints with a 2.3% safety event rate and 63.5% effectiveness rate, showing an 85.3% symptomatic AF recurrence-free rate in treating persistent AF patients.

How much did BSX's WATCHMAN FLX device reduce bleeding compared to anticoagulants?

The device reduced non-procedural bleeding by 44% in concomitant procedures (8.0% vs. 13.3%) and by 62% in sequential procedures (8.8% vs. 21.5%) at 36 months.

What was the stroke protection rate for BSX's WATCHMAN FLX device versus oral anticoagulants?

The WATCHMAN FLX device showed similar stroke protection rates compared to oral anticoagulants: 2.3% vs. 2.5% for concomitant implantation and 1.1% vs 1.6% for sequential implantation.

How many patients were included in BSX's OPTION trial sub-analysis?

The OPTION trial sub-analysis included 1,600 patients with atrial fibrillation who underwent either concomitant or sequential device implantation.