Key result
LVA ablation plus PVI cuts AF/AT recurrence by ~34% versus PVI alone when LAD exceeds 44mm.
Why the study?
In the SUPPRESS-AF trial, LVA ablation efficacy depended on atrial remodeling, prompting evaluation of its efficacy across patient groups stratified by left atrial diameter.
Does pulmonary vein isolation followed by left atrial low-voltage-area ablation improve AF/AT recurrence-free rates in persistent AF patients with left atrial LVAs?
RCT (n=342)
Randomized
Does pulmonary vein isolation followed by left atrial low-voltage-area ablation improve AF/AT recurrence-free rates in persistent AF patients with left atrial LVAs?
Absolute Event Rate: 62.5% vs 43.4%
p-value: p=0.016
Low-voltage-area ablation in addition to PVI significantly improves AF/AT recurrence-free rates in persistent AF patients with advanced left atrial enlargement (LAD > 44 mm).
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Targeting low-voltage areas may benefit persistent AF patients with severe atrial enlargement; extends prior trial.
Masuda et al. (2025) conducted an RCT in Persistent atrial fibrillation with left atrial low-voltage areas (n=342). Pulmonary vein isolation (PVI) followed by left atrial LVA ablation vs. PVI alone was evaluated on AF/AT recurrence-free rate in patients with LAD > 44 mm (p=0.016). Low-voltage-area ablation in addition to PVI improved AF/AT-recurrence-free rates compared to PVI alone in persistent AF patients with a left atrial diameter > 44 mm (62.5% vs. 43.4%, p=0.016).
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