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February 8, 2026Circulation JournalOpen Access

Concomitant Diabetes Mellitus Diminishes the Efficacy of Left Atrial Additional Ablation Following Pulmonary Vein Isolation　― A Subanalysis of the EARNEST-PVI Trial ―

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This research evaluates the impact of diabetes on the efficacy of left atrial additional ablation following pulmonary vein isolation for atrial fibrillation.
Subanalysis of the EARNEST-PVI trial with 493 patients undergoing initial radiofrequency catheter ablation for persistent atrial fibrillation.
Patients randomly assigned to PVI alone or PVI plus additional ablation techniques.
Primary outcome measured was atrial fibrillation recurrence within 12 months of ablation.
AF recurrence observed in 120 (24%) patients overall; 84 (17%) had diabetes mellitus.
In non-diabetic patients, freedom from AF recurrence significantly higher in PVI-plus group (80% vs. 71.1%).
In diabetic patients, similar AF recurrence rates between PVI-plus and PVI-alone groups (75.4% vs. 72.9%).

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Subanalysis reveals reduced freedom from atrial fibrillation in patients with diabetes after additional left atrial ablation.

Matsuda et al. (2026) studied this question.

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