Pulmonary vein isolation combined with CFAE ablation significantly increased the rate of sinus rhythm maintenance compared to CFAE ablation alone (41% vs 9%; P=0.008).
Observational (n=77)
Does a combined approach of CFAE ablation and PVI improve sinus rhythm maintenance compared to CFAE ablation alone in patients with persistent AF?
In patients with persistent AF, combining pulmonary vein isolation with CFAE ablation significantly improves the maintenance of sinus rhythm compared to CFAE ablation alone.
Absolute Event Rate: 41% vs 9%
p-value: p=0.008
AIMS: Ablation of complex fractionated atrial electrograms (CFAEs) is a new approach for the treatment of atrial fibrillation (AF). The purpose of the study was to assess the efficacy of CFAE ablation as a stand-alone strategy in patients with persistent AF and to compare it with a combined approach of CFAE ablation and pulmonary vein isolation (PVI). METHODS AND RESULTS: The study included 77 consecutive patients with persistent AF who underwent radiofrequency (RF) ablation of CFAE as a sole ablation procedure (CFAE group, n = 23 patients) or a combined approach of CFAE ablation and PVI (CFAE plus PVI group, n = 54 patients). Procedures were guided by three-dimensional mapping systems. After the procedure, AF recurrences were evaluated with 7-day Holter recordings at 1, 3, and 6 months and every 6 months thereafter. Treatment failure was defined as >or=1 AF episode lasting >30 s on Holter recordings during follow-up. After a mean follow-up time of 13 +/- 10 months, 2 of 23 patients (9%) with CFAE ablation and 22 of 54 patients (41%) with CFAE plus PVI were in sinus rhythm after a single ablation procedure without anti-arrhythmic medication (P = 0.008). CONCLUSION: Ablation of CFAE as a stand-alone ablation strategy seems insufficient for the treatment of patients with persistent AF. Pulmonary vein isolation plus CFAE ablation significantly increases the mid-term success rate.
Estner et al. (2008) conducted an observational in persistent atrial fibrillation (n=77). CFAE ablation plus pulmonary vein isolation (PVI) vs. CFAE ablation alone was evaluated on Sinus rhythm after a single ablation procedure without anti-arrhythmic medication (p=0.008). Pulmonary vein isolation combined with CFAE ablation significantly increased the rate of sinus rhythm maintenance compared to CFAE ablation alone (41% vs 9%; P=0.008).