Key result
ATP-guided pulmonary vein isolation did not significantly improve 1-year freedom from recurrent atrial tachyarrhythmias compared with conventional PVI (68.7% vs 67.1%; adjusted HR 0.89; P=0.25).
Why the study?
Does ATP-guided PVI reduce recurrent atrial tachyarrhythmias in patients with paroxysmal, persistent, or long-lasting AF compared to conventional PVI?
Population
2113 patients with paroxysmal, persistent, or long-lasting atrial fibrillation
Comparison
Adenosine triphosphate-guided pulmonary vein… vs Conventional pulmonary vein isolation (PVI)
Design
RCT, randomly assigned
Follow-up
1 year
Authors
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ATP-guided PVI should not be adopted routinely; confirms conventional PVI suffices without added ATP testing in AF ablation.
RCT (n=2,113)
Does ATP-guided PVI reduce recurrent atrial tachyarrhythmias in patients with paroxysmal, persistent, or long-lasting AF compared to conventional PVI?
Effect estimate: adjusted HR 0.89 (95% CI 0.74-1.09)
Absolute Event Rate: 68.7% vs 67.1%
p-value: p=0.25
ATP-guided PVI does not significantly reduce the 1-year incidence of recurrent atrial tachyarrhythmias compared with conventional PVI in patients undergoing catheter ablation for atrial fibrillation.
Kobori et al. (2015) conducted an RCT in Atrial fibrillation (n=2,113). ATP-guided pulmonary vein isolation vs. Conventional pulmonary vein isolation was evaluated on Freedom from recurrent atrial tachyarrhythmias lasting for >30 s or those requiring repeat ablation, hospital admission, or usage of Vaughan Williams class I or III antiarrhythmic drugs at 1 year (adjusted HR 0.89, 95% CI 0.74-1.09, p=0.25). ATP-guided pulmonary vein isolation did not significantly improve 1-year freedom from recurrent atrial tachyarrhythmias compared with conventional PVI (68.7% vs 67.1%; adjusted HR 0.89; P=0.25).
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