Left atrial anterior scar in persistent atrial fibrillation: Results with pulmonary vein isolation and linear ablation including posterior mitral line

Q: What does this research mean for the field?

In patients with persistent atrial fibrillation undergoing Marshall-plan ablation, the presence of spontaneous left atrial anterior scar is associated with significantly increased arrhythmia recurrence. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Marine Arnaud; Thomas Pambrun; Xavier Bouteiller; Benjamin Sacristan; Nicolas Johner; Geoffroy Ditac; Laurens Verhaeghe; Francesco Notaristefano; John Fitzgerald; Cinzia Monaco; Konstantinos Vlachos; Marianne Tétreault‐Langlois; Romain Tixier; Josselin Duchâteau; Frédéric Sacher; Mélèze Hocini; Pierre Jais; Michel Haissaguerre; Nicolas Derval

doi:10.1016/j.hroo.2025.11.020

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Why the study?

Outcomes in patients with persistent AF and spontaneous left atrial anterior scar treated with an anatomical ablation set that spares the anterior wall are unknown.

Does the presence of spontaneous left atrial anterior scar reduce AT-AF-free survival in patients with persistent atrial fibrillation undergoing Marshall-plan ablation?

Structured PICO

Does the presence of spontaneous left atrial anterior scar reduce AT-AF-free survival in patients with persistent atrial fibrillation undergoing Marshall-plan ablation?

P

Population

111 consecutive patients with persistent atrial fibrillation (P-AF) referred for AF ablation, including 35 patients with spontaneous left atrial anterior scar and 76 patients with no scar.

I

Intervention

Ablation strategy consisting of pulmonary vein isolation (PVI), vein of Marshall alcoholization (VOH), roof line, posterior mitral line, and cavo-tricuspid isthmus (CTI) line in patients with spontaneous left atrial anterior scar.

C

Comparator

The same ablation strategy in patients with no spontaneous left atrial anterior scar.

O

Outcome

AT-AF-free survival after a first procedure

The presence of spontaneous left atrial anterior scar in patients with persistent AF undergoing Marshall-plan ablation is associated with significantly higher rates of atrial tachycardia/atrial fibrillation recurrence.

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Implication

Spontaneous left atrial scar was associated with higher AT-AF recurrence after Marshall-plan ablation; hypothesis-generating for scar-tailored strategies in persistent AF.

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Cite This Study

Arnaud et al. (2025) studied this question.

synapsesocial.com/papers/6a08bae7ef79633196e8ce34 https://doi.org/10.1016/j.hroo.2025.11.020

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Left atrial anterior scar in persistent atrial fibrillation: Results with pulmonary vein isolation and linear ablation including posterior mitral line

Figures

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Left atrial anterior scar in persistent atrial fibrillation: Results with pulmonary vein isolation and linear ablation including posterior mitral line

Figures

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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